Provider Demographics
NPI:1467930420
Name:KILLEEN EMERGENCY CENTER, LLC
Entity Type:Organization
Organization Name:KILLEEN EMERGENCY CENTER, LLC
Other - Org Name:SIGNATURECARE EMERGENCY CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CUSTOMER SERVICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TRAY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-699-3777
Mailing Address - Street 1:PO BOX 734233
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-7233
Mailing Address - Country:US
Mailing Address - Phone:254-220-4117
Mailing Address - Fax:832-415-0279
Practice Address - Street 1:800 W CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541
Practice Address - Country:US
Practice Address - Phone:254-220-4117
Practice Address - Fax:832-415-0279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-01
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty