Basic Information
| Provider Information | |||||||||
| NPI: | 1548485923 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | TOMBALL EMERGENCY PHYSICIANS, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24727 TOMBALL PKWY | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | TOMBALL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815160911 | ||||||||
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| Practice Location | |||||||||
| Address1: | 24727 TOMBALL PKWY | ||||||||
| Address2: | SUITE 120 | ||||||||
| City: | TOMBALL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815160911 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | KIRBY | ||||||||
| AuthorizedOfficialFirstName: | HOMER | ||||||||
| AuthorizedOfficialMiddleName: | DAVID | ||||||||
| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 2815160911 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.