Provider Demographics
NPI:1336614593
Name:KINGWOOD DRIVE EMERGENCY CENTER, LLC
Entity Type:Organization
Organization Name:KINGWOOD DRIVE EMERGENCY CENTER, LLC
Other - Org Name:NEIGHBORS EMERGENCY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:COTTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-219-3833
Mailing Address - Street 1:11233 SHADOW CREEK PKWY STE 313
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7367
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1120 KINGWOOD DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3043
Practice Address - Country:US
Practice Address - Phone:281-358-8488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTUS HEALTH SYSTEM OPCO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-03
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care