Azle 611 ER Physicians PLLC

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

Legal business name

AZLE 611 ER PHYSICIANS PLLC

Practice address

611 Northwest Parkway
Azle, TX 76020-3654

Phone

(817) 421-0034

Fax

(817) 421-0036

NPI assigned

Feb 1, 2017

Last updated

Feb 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Braxton Neiman, ESQ

Title

General Counsel

Phone

(817) 421-0034

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1485907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485907200000",
    "number": "1306384102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93953",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920119",
            "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": "611 NORTHWEST PARKWAY",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760203654",
            "telephone_number": "817-421-0034",
            "fax_number": "817-421-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZLE 611 ER PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-01",
        "last_updated": "2017-02-01",
        "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_name_prefix": "Mr.",
        "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": []
}

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• Emergency Medical Services (Emergency Medicine) Physician in Azle, TX
• Providers in Azle, TX by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; 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.