Provider Demographics
NPI:1073827978
Name:KISH KOMIE, LP
Entity Type:Organization
Organization Name:KISH KOMIE, LP
Other - Org Name:ER 24-7 PLUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-984-1400
Mailing Address - Street 1:9180 KATY FWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7454
Mailing Address - Country:US
Mailing Address - Phone:713-465-0911
Mailing Address - Fax:
Practice Address - Street 1:9180 KATY FWY
Practice Address - Street 2:SUITE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7454
Practice Address - Country:US
Practice Address - Phone:713-465-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-03
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1376646521OtherMEDICARE ID-TYPE UNSPECIFIED