Provider Demographics
NPI:1689109399
Name:ESS OF TELL CITY, LLC
Entity Type:Organization
Organization Name:ESS OF TELL CITY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-934-3200
Mailing Address - Street 1:17304 PRESTON RD
Mailing Address - Street 2:SUITE 555
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5618
Mailing Address - Country:US
Mailing Address - Phone:972-934-3200
Mailing Address - Fax:
Practice Address - Street 1:8885 STATE ROAD 237
Practice Address - Street 2:
Practice Address - City:TELL CITY
Practice Address - State:IN
Practice Address - Zip Code:47586-8567
Practice Address - Country:US
Practice Address - Phone:812-547-7011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty