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NPI Code Detail

MEDICARE: PHYSICIAN ACUTE CARE SERVICES RICE VILLAGE, PLLC

MEDICARE: PHYSICIAN ACUTE CARE SERVICES RICE VILLAGE, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
100Q5Z4OTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1285178509
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICIAN ACUTE CARE SERVICES RICE VILLAGE, PLLC
Provider Business Mailing Address
First Line : PO BOX 190
Second Line :
City : NEW WAVERLY
State : TX
Zip : 77358-0190
Country : US
Telephone Number : 328-653-3200
Fax Number : 713-808-9176
Provider Business Practice Location Address
First Line : 2500 RICE BLVD
Second Line :
City : HOUSTON
State : TX
Zip : 77005-3221
Country : US
Telephone Number : 713-527-4400
Fax Number : 713-527-4405
Authorized Official
Title or Position : CHIEF EXECUTIVE OFFICER
Name : DR. PATRICIA SHORT
Credential : M.D.
Telephone Number : 832-653-3200
Provider Enumeration Date : 12/05/2016
Last Update Date : 10/05/2023

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