Provider Demographics
NPI:1013322510
Name:CODE 3 EMERGENCY PHYSICIANS, PA
Entity type:Organization
Organization Name:CODE 3 EMERGENCY PHYSICIANS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:DE MOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-320-9820
Mailing Address - Street 1:4701 PAXTON LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-2209
Mailing Address - Country:US
Mailing Address - Phone:469-815-4142
Mailing Address - Fax:
Practice Address - Street 1:400 ENTERPRISE BLVD STE A100
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382
Practice Address - Country:US
Practice Address - Phone:361-529-9400
Practice Address - Fax:361-529-9402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-24
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G6G8OtherBCBS