Provider Demographics
NPI:1003280629
Name:LIFE SAVERS EMERGENCY ROOM LLC
Entity Type:Organization
Organization Name:LIFE SAVERS EMERGENCY ROOM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:FOYEKE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYEMO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-930-1705
Mailing Address - Street 1:17685 TOMBALL PKWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1011
Mailing Address - Country:US
Mailing Address - Phone:832-779-5433
Mailing Address - Fax:
Practice Address - Street 1:17685 TOMBALL PKWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-1011
Practice Address - Country:US
Practice Address - Phone:832-779-5433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160205261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care