MEDICARE: SOUTHWEST EMERGENCY 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	207P00000X	Emergency Medicine Physician		TX

General Provider Information

NPI Number	:	1912276759
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTHWEST EMERGENCY PHYSICIANS, PLLC

Provider Business Mailing Address
First Line	:	14520 MEMORIAL DR
Second Line	:	SUITE 4
City	:	HOUSTON
State	:	TX
Zip	:	77079-5434
Country	:	US
Telephone Number	:	713-554-6300
Fax Number	:

Provider Business Practice Location Address
First Line	:	14520 MEMORIAL DR
Second Line	:	SUITE 4
City	:	HOUSTON
State	:	TX
Zip	:	77079-5434
Country	:	US
Telephone Number	:	713-554-6300
Fax Number	:

Authorized Official
Title or Position	:	ACCOUNT MANAGER
Name	:	MRS. JEAN WINCHER
Credential	:
Telephone Number	:	713-554-6300

Provider Enumeration Date	:	12/23/2011
Last Update Date	:	12/23/2011

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