Provider Demographics
NPI:1730323130
Name:SOUTH TEXAS EMERGENCY PHYSICIANS, PLLP
Entity Type:Organization
Organization Name:SOUTH TEXAS EMERGENCY PHYSICIANS, PLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDISON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-985-1221
Mailing Address - Street 1:4444 CORONA DR STE 215
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4300
Mailing Address - Country:US
Mailing Address - Phone:361-985-1221
Mailing Address - Fax:361-992-1667
Practice Address - Street 1:4444 CORONA DR STE 215
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4300
Practice Address - Country:US
Practice Address - Phone:361-985-1221
Practice Address - Fax:361-992-1667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty