MEDICARE: TOTAL POINT ER ELDRIDGE LLC

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	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1457098832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL POINT ER ELDRIDGE LLC

Provider Business Mailing Address
First Line	:	3514 CEDAR SPRINGS RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-4901
Country	:	US
Telephone Number	:	469-341-7800
Fax Number	:	469-436-7222

Provider Business Practice Location Address
First Line	:	1717 ELDRIDGE PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3567
Country	:	US
Telephone Number	:	713-860-7410
Fax Number	:

Authorized Official
Title or Position	:	CHIEF OPERATING OFFICER
Name	:	VANESSA MADRID
Credential	:
Telephone Number	:	832-740-2301

Provider Enumeration Date	:	05/17/2022
Last Update Date	:	05/17/2022

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