Provider Demographics
NPI:1043888381
Name:SHEPHERD ER PHYSICIANS PA
Entity Type:Organization
Organization Name:SHEPHERD ER PHYSICIANS PA
Other - Org Name:SHEPHERD ER PHYSICIANS PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HORTENCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-526-2320
Mailing Address - Street 1:2320 S SHEPHERD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-7014
Mailing Address - Country:US
Mailing Address - Phone:713-526-2320
Mailing Address - Fax:
Practice Address - Street 1:1324 N SHEPHERD DR # 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-3752
Practice Address - Country:US
Practice Address - Phone:713-526-2320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-14
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043888381OtherSHEPHERD ER PHYSICIANS PA