Provider Demographics
NPI:1154844546
Name:EASTEX ER 2 LLC
Entity Type:Organization
Organization Name:EASTEX ER 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:K9696
Authorized Official - Phone:713-660-0557
Mailing Address - Street 1:5110 ASHBROOK DR STE B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-2942
Mailing Address - Country:US
Mailing Address - Phone:713-660-0557
Mailing Address - Fax:
Practice Address - Street 1:5550 EASTEX FWY
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77708-5329
Practice Address - Country:US
Practice Address - Phone:713-660-0555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care