Provider Demographics
NPI:1639754799
Name:COMMUNITY FIRST ER, LLC
Entity Type:Organization
Organization Name:COMMUNITY FIRST ER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-954-6007
Mailing Address - Street 1:1101 EAST BLVD
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-1909
Mailing Address - Country:US
Mailing Address - Phone:346-954-6007
Mailing Address - Fax:346-954-6222
Practice Address - Street 1:2752 SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-4400
Practice Address - Country:US
Practice Address - Phone:346-955-6006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care