Provider Demographics
NPI:1740866581
Name:TEXAS CRITICAL CARE STAFFING, LLC
Entity type:Organization
Organization Name:TEXAS CRITICAL CARE STAFFING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLISON
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:501-837-3680
Mailing Address - Street 1:46 SANDWELL PL
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-2038
Mailing Address - Country:US
Mailing Address - Phone:501-837-3680
Mailing Address - Fax:
Practice Address - Street 1:14405 WALTERS RD STE 144
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1359
Practice Address - Country:US
Practice Address - Phone:501-837-3680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty