NPIMap

Organization Active NPI

Excellence Emergency Hospital Physician PLLC

  • Clinic/Center
  • Houston, TX
National Provider Identifier
1972223675
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 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
Last updated
Sep 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Authorized official

Name
Inam Khan
Title
Manager
Phone
(832) 457-4920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

15149 Wallisville Road
Houston, TX 77049-4619

Mailing address

15149 Wallisville Road
Houston, TX 77049-4619
Phone (832) 400-2396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221103003033 TX Part B Supplier - Clinic/Group Practice 4284001280 Receives reassigned benefits from 57 practitioners
Practice locations: Houston, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 58

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 58

NPI Registry JSON

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

{
    "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. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.