Colonial Lakes Medical Center LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

License

160127 Issued in TX

Legal business name

COLONIAL LAKES MEDICAL CENTER LLC

Practice address

4885 Hwy 6
Missouri City, TX 77459

Phone

(972) 899-6666

Fax

(972) 899-5954

NPI assigned

Jan 30, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tim Fielding

Title

Cfo

Phone

(972) 899-6666

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• First Choice Emergency Room Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1134542954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840795",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840795",
            "telephone_number": "972-899-6666",
            "fax_number": "972-899-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4885 HWY 6",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "77459",
            "telephone_number": "972-899-6666",
            "fax_number": "972-899-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL LAKES MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "FIELDING",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "972-899-6666"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "TX",
            "license": "160127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JCAHO",
            "identifier": "434148",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Choice Emergency Room",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Emergency Care Clinic/Center in Missouri City, TX
• Providers in Missouri City, TX by specialty
• Emergency Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.