Provider Demographics
NPI:1558792077
Name:SOUTH TEXAS ER
Entity Type:Organization
Organization Name:SOUTH TEXAS ER
Other - Org Name:PHYSICIANS PREMIER EMERGENCY ROOM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NORDLOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-770-7351
Mailing Address - Street 1:5521 SARATOGA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2843
Mailing Address - Country:US
Mailing Address - Phone:310-770-7351
Mailing Address - Fax:
Practice Address - Street 1:6107 RUSTIC CREEK LN
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-1972
Practice Address - Country:US
Practice Address - Phone:310-770-7351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care