Provider Demographics
NPI:1003218405
Name:PLANO S D DOW EMERGENCY,LLC
Entity Type:Organization
Organization Name:PLANO S D DOW EMERGENCY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KASHIF
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-730-6204
Mailing Address - Street 1:2401 FOUNTAIN VIEW DR
Mailing Address - Street 2:STE 808
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4820
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2401 FOUNTAIN VIEW DR
Practice Address - Street 2:STE 808
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4820
Practice Address - Country:US
Practice Address - Phone:469-730-6204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care