Provider Demographics
NPI:1508242777
Name:MONTROSE EMERGENCY CENTER
Entity Type:Organization
Organization Name:MONTROSE EMERGENCY CENTER
Other - Org Name:SIGNATURE CARE EMGERGENCY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KANTI
Authorized Official - Middle Name:
Authorized Official - Last Name:BANSAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-944-8047
Mailing Address - Street 1:PO BOX 821028
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77282-1028
Mailing Address - Country:US
Mailing Address - Phone:832-699-3777
Mailing Address - Fax:
Practice Address - Street 1:1007 WESTHEIMER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2724
Practice Address - Country:US
Practice Address - Phone:281-944-8047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160178207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty