Organization Active NPI

Emergency Service Staffing PA

  • Emergency Medicine Physician
  • Bryan, TX
National Provider Identifier
1215975396
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
EMERGENCY SERVICE STAFFING PA
Practice address
2801 Franciscan Dr
Bryan, TX 77802-2544
Phone
(979) 776-3777
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sam Roberts, MD
Title
President
Phone
(512) 452-8533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

2801 Franciscan Dr
Bryan, TX 77802-2544

Mailing address

720 W 34TH St
Suite 101
Austin, TX 78705-1240
Phone (512) 452-8533

Other identifiers 2

IdentifierTypeStateIssuer
DE8976OtherTXRAILROAD MEDICARE
0022DJOtherTXBCBS

National Provider Directory

National Provider Directory
Tax ID family
Emergency Service Staffing PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

720 W 34th St
Ste 101
Austin, TX 78705
Phone (512) 610-0317

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215975396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W 34TH ST",
            "address_2": "SUITE 101",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051240",
            "telephone_number": "512-452-8533",
            "fax_number": "512-452-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 FRANCISCAN DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022544",
            "telephone_number": "979-776-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY SERVICE STAFFING PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-452-8533",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE8976",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0022DJ",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.