Provider Demographics
NPI:1033594890
Name:PROVIDENCE ER OF SPRING, PLLC
Entity Type:Organization
Organization Name:PROVIDENCE ER OF SPRING, PLLC
Other - Org Name:CYPRESS CREEK ER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINH
Authorized Official - Middle Name:J
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-453-7916
Mailing Address - Street 1:20320 NORTHWEST FWY STE 900
Mailing Address - Street 2:
Mailing Address - City:JERSEY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5620
Mailing Address - Country:US
Mailing Address - Phone:281-586-3888
Mailing Address - Fax:281-440-2020
Practice Address - Street 1:5037-B FM 2920
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388
Practice Address - Country:US
Practice Address - Phone:281-453-2595
Practice Address - Fax:281-440-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-22
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
No282N00000XHospitalsGeneral Acute Care Hospital