Provider Demographics
NPI:1184048068
Name:EC MANSFIELD, LLC
Entity type:Organization
Organization Name:EC MANSFIELD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-784-1500
Mailing Address - Street 1:211 HIGHLAND CROSS DR
Mailing Address - Street 2:SUITE 275
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-1733
Mailing Address - Country:US
Mailing Address - Phone:281-784-1500
Mailing Address - Fax:281-209-8930
Practice Address - Street 1:1710 HIGHWAY 287 N
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7534
Practice Address - Country:US
Practice Address - Phone:817-225-4570
Practice Address - Fax:281-209-8930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160102261QE0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXHH106EOtherBCBSTX