Provider Demographics
NPI:1265666754
Name:PINELOCH EMERGENCY CARE
Entity Type:Organization
Organization Name:PINELOCH EMERGENCY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-898-9174
Mailing Address - Street 1:1051 PINELOCH DR
Mailing Address - Street 2:STE 700
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2742
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1051 PINELOCH DR
Practice Address - Street 2:STE 700
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2742
Practice Address - Country:US
Practice Address - Phone:281-990-9979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center