Provider Demographics
NPI:1174974448
Name:EMERGENCY PHYSICIAN ALLIANCE, INC
Entity type:Organization
Organization Name:EMERGENCY PHYSICIAN ALLIANCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO CMO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUESKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-784-1500
Mailing Address - Street 1:2530 GULF FWY S
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6743
Mailing Address - Country:US
Mailing Address - Phone:281-784-1500
Mailing Address - Fax:281-209-8930
Practice Address - Street 1:2530 GULF FWY S
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6743
Practice Address - Country:US
Practice Address - Phone:281-784-1500
Practice Address - Fax:281-209-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty