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Organization
TEXAS EM-1 MEDICAL SERVICES, PA
Active
Organization
TEXAS EM-1 MEDICAL SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM C. JERNBERG MD (PRESIDENT)
(214) 712-2000
Entity
Organization
Contact information
Practice address
115 AIRPORT RD, SULPHUR SPRINGS, TX 75482-2105
(903) 885-7671
Mailing address
1717 MAIN ST, SUITE 5200, DALLAS, TX 75201-4612
(214) 712-2000
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055QQ
BCBS
TX
05
—
152242709
—
TX
Enumeration date
10/04/2007
Last updated
01/19/2021
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