Provider Demographics
NPI:1558844258
Name:PREMIER ER PLUS, SAN MARCOS, LLC
Entity Type:Organization
Organization Name:PREMIER ER PLUS, SAN MARCOS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-224-8808
Mailing Address - Street 1:900 AUSTIN AVE STE 1001
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76701-1949
Mailing Address - Country:US
Mailing Address - Phone:254-224-8808
Mailing Address - Fax:254-224-6590
Practice Address - Street 1:1509 N INTERSTATE 35
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7220
Practice Address - Country:US
Practice Address - Phone:512-648-6188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care