PHYSICIANS PREMIER EMERGENCY ROOM – NPI #1093191397
Clinic/Center

PHYSICIANS PREMIER EMERGENCY ROOM is an AHC clinic located in PORTLAND, TX. NPPES has assigned the NPI number 1093191397 to PHYSICIANS PREMIER EMERGENCY ROOM on August 10, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PHYSICIANS PREMIER EMERGENCY ROOM” is a dba name, the actual legal business name for this organization is COASTAL ER III, LLC. The primary taxonomy selected by this provider is 261QE0002X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Emergency Care

The NPI profile was previously updated about 2 years ago on Jan 11, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PHYSICIANS PREMIER EMERGENCY ROOM below.

NPI Profile for
COASTAL ER III, LLC

NPI Number
1093191397
Enumeration Date

(about 11 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
COASTAL ER III, LLC
Doing Business As (dba): PHYSICIANS PREMIER EMERGENCY ROOM
Primary location
1860 HIGHWAY 181 FRONTAGE ROAD
STE C
PORTLAND, TX 78374
Phone: (361) 991-0912 Fax:
Mailing address
PO BOX 6040
CORPUS CHRISTI, TX 78466-6040
Phone: (361) 723-0226 Fax: (512) 852-4625
Organization Subpart
No
Authorized Official
CHRISTOPHER KWON
MANAGER
Phone: (361) 991-0912
Updated
Certification Date
Jan 11, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QE0002X
- Clinic/Center / Emergency Care (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.