Provider Demographics
NPI:1437381704
Name:KP MEDICAL CENTER
Entity Type:Organization
Organization Name:KP MEDICAL CENTER
Other - Org Name:FIRST CHOICE EMERGENCY ROOM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNTS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:VAUGHN
Authorized Official - Last Name:BARTRUFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-899-6626
Mailing Address - Street 1:2624 LONG PRAIRIE RD
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4839
Mailing Address - Country:US
Mailing Address - Phone:972-899-6650
Mailing Address - Fax:972-899-6665
Practice Address - Street 1:2624 LONG PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4839
Practice Address - Country:US
Practice Address - Phone:972-899-6650
Practice Address - Fax:972-899-6665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care