Provider Demographics
NPI:1841620036
Name:INTEGRATED EMERGENCY CARE SERVICES PLLC
Entity Type:Organization
Organization Name:INTEGRATED EMERGENCY CARE SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LONG
Authorized Official - Middle Name:N
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-878-8604
Mailing Address - Street 1:3130 GRANTS LAKE BLVD
Mailing Address - Street 2:18917
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77496-0978
Mailing Address - Country:US
Mailing Address - Phone:832-878-8604
Mailing Address - Fax:
Practice Address - Street 1:1211 HIGHWAY 6
Practice Address - Street 2:SUITE 70
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4941
Practice Address - Country:US
Practice Address - Phone:281-238-3902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty