Azle 611 ER Physicians PLLC
Organization Active NPI Emergency Medical Services (Emergency Medicine) Physician · Azle, TX
NPI 1306384102 · NPPES record last updated Feb 1, 2017
Key facts
- NPI
- 1306384102
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician 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
- Organization subpart
- No
Authorized official
- Name
- Mr. John Braxton Neiman, ESQ
- Title
- General Counsel
- Phone
- (817) 421-0034
National Provider Directory
Locations
611 Northwest Pkwy
Azle, TX 76020
Phone (817) 270-0777
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician |
207PE0004X | Yes |
Addresses
Primary practice location
611 Northwest Parkway
Azle, TX 76020-3654
Mailing address
PO Box 93953
Southlake, TX 76092-0119
Phone (817) 421-0034
Other providers in Azle, TX
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- Omair Atiq
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All providers in Azle, TX · Emergency Medical Services (Emergency Medicine) Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.