Provider Demographics
NPI:1801578950
Name:MSER PHYSICIAN GROUP PLLC
Entity type:Organization
Organization Name:MSER PHYSICIAN GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:ENEKEBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-899-6737
Mailing Address - Street 1:4057 RILEY FUZZEL RD STE 500-418
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5037B FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-3114
Practice Address - Country:US
Practice Address - Phone:346-899-6737
Practice Address - Fax:346-380-2161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty