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)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
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

All providers in Azle, TX · Emergency Medical Services (Emergency Medicine) Physician in Texas

Sources for this page

Verify at the official NPI Registry.