Provider Demographics
NPI:1134417439
Name:EMERGENCY MEDICAL GROUP, LLC
Entity type:Organization
Organization Name:EMERGENCY MEDICAL GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-784-1500
Mailing Address - Street 1:2500 RICE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-3221
Mailing Address - Country:US
Mailing Address - Phone:713-527-4400
Mailing Address - Fax:281-784-1653
Practice Address - Street 1:2500 RICE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-3221
Practice Address - Country:US
Practice Address - Phone:713-527-4400
Practice Address - Fax:281-784-1653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160025261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH0HH031EOtherBLUE CROSS BLUE SHIELD OF TEXAS
TX160025OtherFREESTANDING EMERGENCY MEDICAL CARE FACILITY