Provider Demographics
NPI:1205494101
Name:HULEN ER LLC
Entity type:Organization
Organization Name:HULEN ER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-894-9436
Mailing Address - Street 1:5900 S HULEN ST
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4820
Mailing Address - Country:US
Mailing Address - Phone:817-894-9436
Mailing Address - Fax:
Practice Address - Street 1:5900 S HULEN ST
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4820
Practice Address - Country:US
Practice Address - Phone:817-769-1533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ER HULEN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-05
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care