Provider Demographics
NPI:1184875650
Name:SOUTH ARLINGTON EMERGENCY MEDICINE ASSOCIATES PLLC
Entity type:Organization
Organization Name:SOUTH ARLINGTON EMERGENCY MEDICINE ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL PRINCIPE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-472-3400
Mailing Address - Street 1:DEPT 960296
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0296
Mailing Address - Country:US
Mailing Address - Phone:888-447-2450
Mailing Address - Fax:
Practice Address - Street 1:801 INTERSTATE 20 W
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5851
Practice Address - Country:US
Practice Address - Phone:817-472-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200620701Medicaid
TX0092RVOtherBCBS
614570900OtherDEPT OF LABOR FECA
TX0A0283Medicare PIN