Provider Demographics
NPI:1477097129
Name:GRAMERCY EMERGENCY CENTER VICTORIA LLC
Entity Type:Organization
Organization Name:GRAMERCY EMERGENCY CENTER VICTORIA LLC
Other - Org Name:MERCER EMERGENCY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-385-8213
Mailing Address - Street 1:PO BOX 46069
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-6069
Mailing Address - Country:US
Mailing Address - Phone:800-962-3303
Mailing Address - Fax:
Practice Address - Street 1:6902 NE ZAC LENTZ PKWY
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3441
Practice Address - Country:US
Practice Address - Phone:800-962-3303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care