Provider Demographics
NPI:1164910360
Name:USA EMERGENCY CENTERS-RIVERSTONE, LLC
Entity Type:Organization
Organization Name:USA EMERGENCY CENTERS-RIVERSTONE, LLC
Other - Org Name:HOSPITALITY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-389-3318
Mailing Address - Street 1:PO BOX 61160
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-1160
Mailing Address - Country:US
Mailing Address - Phone:361-884-2904
Mailing Address - Fax:361-884-1912
Practice Address - Street 1:4734 L J PKWY UNIT 310
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:361-884-2904
Practice Address - Fax:361-884-2919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care