Provider Demographics
NPI:1639663370
Name:USA EMERGENCY CENTERS - ROUND ROCK, LLC
Entity Type:Organization
Organization Name:USA EMERGENCY CENTERS - ROUND ROCK, LLC
Other - Org Name:ALLY MEDICAL EMERGENCY ROOM ROUND ROCK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GOVERNING BOARD MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTION
Authorized Official - Middle Name:
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-451-0911
Mailing Address - Street 1:5525 BURNET RD STE A
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-1646
Mailing Address - Country:US
Mailing Address - Phone:512-451-0911
Mailing Address - Fax:512-255-6030
Practice Address - Street 1:2105 E PALM VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-4566
Practice Address - Country:US
Practice Address - Phone:512-255-0911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-17
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160364261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160364OtherFREE STANDING EMERGENCY MEDICAL CARE FACILITY