Excellence Emergency Hospital Physician PLLC
Organization Active NPI Clinic/Center · Houston, TX
NPI 1972223675 · NPPES record last updated Sep 1, 2022
Key facts
- NPI
- 1972223675
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- EXCELLENCE EMERGENCY HOSPITAL PHYSICIAN PLLC
- Practice address
- 15149 Wallisville Road
Houston, TX 77049-4619 - Phone
- (832) 400-2396
- NPI assigned
- Sep 1, 2022
- Organization subpart
- No
Authorized official
- Name
- Inam Khan
- Title
- Manager
- Phone
- (832) 457-4920
Practitioners 58
-
Gultasib Khan Gill, M.D.
-
Adriano Enrico Goffi, M.D.
-
Shariq Khan, M.D.
-
Scott Freland Thames Jr., M.D.
-
Mai Abouelsaad, M.D.
-
Zunair Ahmad, MD
-
Darshan P Anandu, M.D.
-
Nelson K Bond, MD
-
William Fernando Buitrago, M.D., PH.D.
-
Muhammad Farhan, FNP
-
Danny Farley, M.D.
-
Mohammed A Farooqui, DPM
-
Michael Heard, M.D.
-
James Jackson, M.D.
-
Aisha B Khattak, M.D.
-
Ankur Khosla, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221103003033 | TX | Part B Supplier - Clinic/Group Practice | 4284001280 |
Receives reassigned benefits from 57 practitioners Practice locations: Houston, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
15149 Wallisville Road
Houston, TX 77049-4619
Mailing address
15149 Wallisville Road
Houston, TX 77049-4619
Phone (832) 400-2396
NPI Registry JSON
{
"created_epoch": "1661990400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1661990400000",
"number": "1972223675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15149 WALLISVILLE ROAD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770494619",
"telephone_number": "832-400-2396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15149 WALLISVILLE ROAD",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770494619",
"telephone_number": "832-400-2396"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXCELLENCE EMERGENCY HOSPITAL PHYSICIAN PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-01",
"last_updated": "2022-09-01",
"certification_date": "2022-08-30",
"status": "A",
"authorized_official_last_name": "KHAN",
"authorized_official_first_name": "INAM",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "832-457-4920"
},
"taxonomies": [
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"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. Record last updated by the provider on Sep 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.