MEDICARE: CEC ARLINGTON ER PHYSICIANS 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
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician

General Provider Information

NPI Number	:	1336532258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CEC ARLINGTON ER PHYSICIANS PLLC

Provider Business Mailing Address
First Line	:	PO BOX 92758
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-0758
Country	:	US
Telephone Number	:	817-421-0034
Fax Number	:	817-421-0036

Provider Business Practice Location Address
First Line	:	4700 LITTLE RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-1058
Country	:	US
Telephone Number	:	817-421-0034
Fax Number	:	817-421-0036

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	JOHN NEIMAN
Credential	:	ESQ.
Telephone Number	:	817-421-0034

Provider Enumeration Date	:	03/17/2015
Last Update Date	:	01/25/2016

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