Provider Demographics
NPI:1447200696
Name:TEXAS EMERGENCY ROOM SERVICES PA
Entity Type:Organization
Organization Name:TEXAS EMERGENCY ROOM SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:GATEWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:800-444-7009
Mailing Address - Street 1:815 S PALAFOX ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5937
Mailing Address - Country:US
Mailing Address - Phone:800-444-7009
Mailing Address - Fax:800-305-3233
Practice Address - Street 1:801 N BEDELL AVE
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4112
Practice Address - Country:US
Practice Address - Phone:830-706-3170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDD0314Medicare PIN
TX00400YMedicare PIN