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Organization
BECK EMERGENCY PHYSICIANS
Active
Organization
BECK EMERGENCY PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM C. JERNBERG M.D. (PRESIDENT)
(214) 712-2000
Entity
Organization
Contact information
Practice address
2850 STATE HIGHWAY 114 E, TROPHY CLUB, TX 75146
(972) 548-7277
(214) 712-2487
Mailing address
PO BOX 41556, PHILADELPHIA, PA 19101-1556
(800) 355-3818
(214) 712-2487
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0027NH
BLUE SHIELD
TX
Enumeration date
06/15/2006
Last updated
04/20/2008
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