Waterside Medical Center LLC

Primary specialty

Emergency Care Clinic/CenterTaxonomy code 261QE0002X

License

160146 Issued in TX

Legal business name

WATERSIDE MEDICAL CENTER LLC

Practice address

8111 West Grand Parkway S
Richmond, TX 77407

Phone

(972) 899-6650

Fax

(972) 899-5954

NPI assigned

May 2, 2014

Organization subpart

No

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

Authorized official

Name

Tim Fielding

Title

Cfo

Phone

(972) 899-6650

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• First Choice Emergency Room Doing business as

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427760000000",
    "number": "1457761231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840795",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840795",
            "telephone_number": "972-899-6650",
            "fax_number": "972-899-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 WEST GRAND PARKWAY S",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "77407",
            "telephone_number": "972-899-6650",
            "fax_number": "972-899-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERSIDE MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2015-03-31",
        "status": "A",
        "authorized_official_last_name": "FIELDING",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "972-899-6650"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "TX",
            "license": "160146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JCAHO",
            "identifier": "434148",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Choice Emergency Room",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nina Ward, MSW
• Wash Camair LLC
• Ifeyinwa Washington
• Jaunquil E Washington, RBT
• Yousrah Wasim
• Waterside Urgent Care Partners LP
• Sadia E Wazir, RPH
• We Care Ambassadors of Health Inc
• Jessica Weaver, LMFT
• Angella Webb

• Emergency Care Clinic/Center in Richmond, TX
• Providers in Richmond, TX by specialty
• Emergency Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; 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.