Basic Information
| Provider Information | |||||||||
| NPI: | 1831624543 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ER-MD PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3508 STIRLING ST | ||||||||
| Address2: | |||||||||
| City: | WICHITA FALLS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 763101723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9406898234 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3508 STIRLING ST | ||||||||
| Address2: | |||||||||
| City: | WICHITA FALLS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 763101723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9406898234 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2017 | ||||||||
| LastUpdateDate: | 05/01/2017 | ||||||||
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| AuthorizedOfficialLastName: | MATTAR | ||||||||
| AuthorizedOfficialFirstName: | AHMED | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE MEMBER/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9406898234 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.