Provider Demographics
NPI:1487854568
Name:2920 ER, LLC
Entity Type:Organization
Organization Name:2920 ER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSHMA
Authorized Official - Middle Name:
Authorized Official - Last Name:GORRELA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-257-0404
Mailing Address - Street 1:PO BOX 11012
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77391-1012
Mailing Address - Country:US
Mailing Address - Phone:281-257-0404
Mailing Address - Fax:281-257-0447
Practice Address - Street 1:6225 FM 2920 RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3474
Practice Address - Country:US
Practice Address - Phone:281-257-0404
Practice Address - Fax:281-257-0447
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:2920 MEDICAL MANAGEMENT GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-18
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care