Provider Demographics
NPI:1740950179
Name:KINGWOOD ER LLC
Entity type:Organization
Organization Name:KINGWOOD ER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:MOATH
Authorized Official - Middle Name:J
Authorized Official - Last Name:AMRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-977-7800
Mailing Address - Street 1:2158 NORTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1745
Mailing Address - Country:US
Mailing Address - Phone:832-995-0415
Mailing Address - Fax:832-995-0415
Practice Address - Street 1:2158 NORTHPARK DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1745
Practice Address - Country:US
Practice Address - Phone:281-977-7800
Practice Address - Fax:832-995-0415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care