Organization Active NPI

Memorial Village Emergency Room

  • Emergency Medicine Physician
  • Houston, TX
National Provider Identifier
1376064295
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MEMORIAL VILLAGE EMERGENCY ROOM
Practice address
14520 Memorial Dr Ste 4
Houston, TX 77079-5415
Phone
(281) 496-6837
NPI assigned
Jun 30, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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

Authorized official

Name
Mr. Jason Mesvero, RN BSN
Title
Facility Administrator
Phone
(281) 501-2841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

14520 Memorial Dr Ste 4
Houston, TX 77079-5415

Mailing address

14520 Memorial Dr Ste 4
Houston, TX 77079-5415

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2128748Memorial Village Emergency Room14520 Memorial Drive Suite 4, Houston, TX 77079AccreditationMay 23, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498780800000",
    "number": "1376064295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14520 MEMORIAL DR STE 4",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770795415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14520 MEMORIAL DR STE 4",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770795415",
            "telephone_number": "281-496-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL VILLAGE EMERGENCY ROOM",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-30",
        "last_updated": "2017-06-30",
        "status": "A",
        "authorized_official_last_name": "MESVERO",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "281-501-2841",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RN BSN"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.