Excellence Emergency Hospital LLC

Organization Active NPI General Acute Care Hospital · Houston, TX

NPI 1972258580 · NPPES record last updated Oct 4, 2022

Key facts

NPI
1972258580
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
Legal business name
EXCELLENCE EMERGENCY HOSPITAL LLC
Practice address
15149 Wallisville Road
Houston, TX 77049
Phone
(281) 864-0448
NPI assigned
Feb 14, 2022
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 32

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 32

Medicare Care Compare: Hospital

Listed as
East Houston Medical Center CCN 670320
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Hospital certification: CCN 670320

Legal name
EXCELLENCE EMERGENCY HOSPITAL LLC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jun 2, 2023
Last certification
Jun 2, 2023
Beds
4
Ownership / control type
Private (for profit)
Organization structure
LLC · Proprietary
Enrollment address
15149 Wallisville Rd
Houston, TX 77049-4619
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Excellence Emergency Hospital LLC
Organization · Houston, TX
LLC
5% Or Greater Direct Ownership Interest Apr 26, 2019 100%
Inam Khan
Individual
W-2 Managing Employee
Coo
Jul 26, 2022 100%
Kashif H Ansari
Individual
5% Or Greater Direct Ownership Interest
Owner
Apr 26, 2019 100%

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20220914003774 TX Part a Provider - Hospital 1850776667 Practice locations: Houston, TX

National Provider Directory

Tax ID family
East Houston Medical Center PLLC (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Yes

Addresses

Primary practice location

15149 Wallisville Road
Houston, TX 77049

Mailing address

15149 Wallisville Road
Houston, TX 77049

Other names

  • East Houston Medical Center PLLC Doing business as

Other providers in Houston, TX

All providers in Houston, TX · General Acute Care Hospital in Texas

Sources for this page

Verify at the official NPI Registry.