Provider Demographics
NPI:1487186649
Name:MEMORIAL VILLAGE EMERGENCY PHYSICIANS
Entity Type:Organization
Organization Name:MEMORIAL VILLAGE EMERGENCY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:COVERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-699-3777
Mailing Address - Street 1:14520 MEMORIAL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-5434
Mailing Address - Country:US
Mailing Address - Phone:281-496-6837
Mailing Address - Fax:281-496-2143
Practice Address - Street 1:14520 MEMORIAL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-5434
Practice Address - Country:US
Practice Address - Phone:281-496-6837
Practice Address - Fax:281-496-2143
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEMORIAL VILLAGE EMERGENCY ROOM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty