Stephenville 2108 ER Physicians PLLC

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

Legal business name

STEPHENVILLE 2108 ER PHYSICIANS PLLC

Practice address

2108 W Washington St
Stephenville, TX 76401-3928

Phone

(817) 421-0012

Fax

(817) 421-0036

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Braxton Neiman

Title

General Counsel

Phone

(817) 421-0034

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509408000000",
    "number": "1619403763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93741",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760920117",
            "telephone_number": "817-421-0012",
            "fax_number": "817-421-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 W WASHINGTON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013928",
            "telephone_number": "817-421-0012",
            "fax_number": "817-421-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHENVILLE 2108 ER PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-10-31",
        "status": "A",
        "authorized_official_last_name": "NEIMAN",
        "authorized_official_first_name": "BRAXTON",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "817-421-0034"
    },
    "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 Stephenville, TX
• Providers in Stephenville, 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 Oct 31, 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.