Bonita Creek Emergency Services Pllc

LBN: Bonita Creek Emergency Services Pllc
Bonita Creek Emergency Services Pllc is an health care organization with primary practice located at 1204 N Mound St , Nacogdoches TX 75961-4027. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as the primary health care specialty. Bonita Creek Emergency Services Pllc can be contacted via phone (936) 564-4611, or through Corley, Adam via phone (337) 277-6355.

Contact Information

Primary practice address
1204 N Mound St Nacogdoches TX 75961-4027
Phone: (936) 564-4611
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Corley, Adam Doctor of Medicine (MD)
Phone: (337) 277-6355

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X

Profile Details

NPI number 1902555485
LBN Legal business name Bonita Creek Emergency Services Pllc
DBA Doing business as
Authorized official Corley, Adam Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 22nd, 2022
Last updated Jan 9th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902555485 NPPES
Texas Other 12345 MEDICAID

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