Organization Active NPI

Momentum ER Physicians PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Tyler, TX
National Provider Identifier
1255883625
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
MOMENTUM ER PHYSICIANS PLLC
Practice address
5011 Troup Hwy
100
Tyler, TX 75707-2562
Phone
(817) 421-0034
Fax
(817) 421-0036
NPI assigned
Nov 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Authorized official

Name
John Braxton Neiman, ESQ.
Title
General Counsel
Phone
(817) 421-0034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207PE0004X Primary

Addresses

Primary practice location

5011 Troup Hwy
100
Tyler, TX 75707-2562

Mailing address

PO Box 93714
Southlake, TX 76092-0116
Phone (817) 421-0034

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1255883625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93714",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920116",
            "telephone_number": "817-421-0034",
            "fax_number": "817-421-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5011 TROUP HWY",
            "address_2": "100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757072562",
            "telephone_number": "817-421-0034",
            "fax_number": "817-421-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMENTUM ER PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "NEIMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BRAXTON",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "817-421-0034",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.