NPIMap

Organization Active NPI

USA Emergency Centers - Clear Lake, LLC

Doing business as Ally Medical Emergency Room Clear Lake

  • Emergency Care Clinic/Center
  • Houston, TX
National Provider Identifier
1891210639
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
160329 Issued in TX
Legal business name
USA EMERGENCY CENTERS - CLEAR LAKE, LLC
Doing business as
Ally Medical Emergency Room Clear Lake
Practice address
3351 Clear Lake City Blvd Ste 100
Houston, TX 77059-2513
Phone
(281) 280-0911
NPI assigned
Aug 12, 2017
Last updated
Mar 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Authorized official

Name
Dr. Jared T Shahan, MDNPI 1518144773
Title
Governing Board Member
Phone
(512) 451-0911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X 160329 TX Primary

Addresses

Primary practice location

3351 Clear Lake City Blvd Ste 100
Houston, TX 77059-2513

Mailing address

5525 Burnet Rd Ste a
Austin, TX 78756-1646
Phone (512) 451-0911

Other identifiers 1

IdentifierTypeStateIssuer
160329OtherTXFREESTANDING EMERGENCY CENTER LICENSE

Other names 3

  • Ally Medical Emergency Room Clear Lake Doing business as
  • Ally Medical Other name
  • Physicians PremiER Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891210639. Details of each certification follow.

Hospital certification: CCN 670247

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ALLY MEDICAL
Certification status
Terminated Voluntary: merger or closure, May 11, 2023
Provider type (POS)
Hospital – Short-term
Participating since
May 12, 2020
Last certification
May 12, 2020
Beds
1
Ownership / control type
Private (not for profit)
Facility address
3351 Clear Lake City Blvd., Suite 100
Houston, TX 77059

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
45D2134262Ally Medical Emergency Room - Clear Lake3351 Clear Lake City Blvd Suite 100, Houston, TX 77059AccreditationJun 12, 2028

National Provider Directory

National Provider Directory

Locations

3351 Clear Lake City Blvd
Ste 100
Houston, TX 77059
Phone (281) 280-0911

Practitioners & affiliated clinicians

Practitioners 47

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 47

NPI Registry JSON

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

{
    "created_epoch": "1502496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1891210639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 BURNET RD STE A",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787561646",
            "telephone_number": "512-451-0911",
            "fax_number": "281-280-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3351 CLEAR LAKE CITY BLVD STE 100",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770592513",
            "telephone_number": "281-280-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USA EMERGENCY CENTERS - CLEAR LAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-12",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "SHAHAN",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "GOVERNING BOARD MEMBER",
        "authorized_official_telephone_number": "512-451-0911",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "TX",
            "license": "160329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREESTANDING EMERGENCY CENTER LICENSE",
            "identifier": "160329",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ally Medical Emergency Room Clear Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ally Medical",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ally Medical",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Physicians PremiER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.