MEDICARE: MONTROSE EMERGENCY CENTER

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	207P00000X	Emergency Medicine Physician	160178	TX

General Provider Information

NPI Number	:	1508242777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONTROSE EMERGENCY CENTER

Provider Business Mailing Address
First Line	:	PO BOX 821028
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77282-1028
Country	:	US
Telephone Number	:	832-699-3777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1007 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77006-2724
Country	:	US
Telephone Number	:	281-944-8047
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KANTI BANSAL
Credential	:	M.D.
Telephone Number	:	281-944-8047

Provider Enumeration Date	:	08/10/2015
Last Update Date	:	08/10/2015

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Directions to “MONTROSE EMERGENCY CENTER ” Practice Location

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