MEDICARE: EMER HULEN, 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	207P00000X	Emergency Medicine Physician
2	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1740911213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMER HULEN, LLC

Provider Business Mailing Address
First Line	:	2300 MATLOCK RD STE 35
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-5018
Country	:	US
Telephone Number	:	469-830-8200
Fax Number	:	469-830-8201

Provider Business Practice Location Address
First Line	:	5900 S HULEN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76132-4820
Country	:	US
Telephone Number	:	214-390-7697
Fax Number	:	972-432-6692

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MICHELLE NEWSOM
Credential	:
Telephone Number	:	469-830-8200

Provider Enumeration Date	:	06/23/2022
Last Update Date	:	09/27/2024

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Directions to “EMER HULEN, LLC ” Practice Location

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