MEDICARE: ORANGE ER, 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	:	1679976278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORANGE ER, LLC

Provider Business Mailing Address
First Line	:	3107 EDGAR BROWN DR
Second Line	:
City	:	WEST ORANGE
State	:	TX
Zip	:	77630-5347
Country	:	US
Telephone Number	:	409-920-4470
Fax Number	:	409-920-4480

Provider Business Practice Location Address
First Line	:	3107 EDGAR BROWN DR
Second Line	:
City	:	WEST ORANGE
State	:	TX
Zip	:	77630-5347
Country	:	US
Telephone Number	:	409-237-5870
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	KARI MARIE BUSCH
Credential	:
Telephone Number	:	409-920-4470

Provider Enumeration Date	:	09/27/2014
Last Update Date	:	03/18/2025

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