Provider Demographics
NPI:1659057081
Name:MEMORIAL SPRINGS ER LLC
Entity Type:Organization
Organization Name:MEMORIAL SPRINGS ER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:ENEKEBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-605-5998
Mailing Address - Street 1:4057 RILEY FUZZEL RD STE 500-418
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5037B FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3114
Practice Address - Country:US
Practice Address - Phone:346-849-6737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care