Piney Woods ER LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

Legal business name

PINEY WOODS ER LLC

Practice address

6718 S Broadway Ave
Tyler, TX 75703-4730

Phone

(903) 509-0911

NPI assigned

Jan 8, 2015

Organization subpart

No

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

Authorized official

Name

Christopher Kwon, M.D.

Title

Owner

Phone

(903) 509-0911

Specialties & licenses 1

Addresses

Other names 1

• Excel ER Doing business as

Locations

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451433600000",
    "number": "1215325642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6718 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034730",
            "telephone_number": "903-509-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6718 S BROADWAY AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757034730",
            "telephone_number": "903-509-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEY WOODS ER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-12-30",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-509-0911",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excel ER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Melanie Joyce Pinkston, COTA

• Emergency Care Clinic/Center in Tyler, TX
• Providers in Tyler, 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 Dec 30, 2015; 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.