# BANDERA EMERGENCY PHYSICIANS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649994930
- **Authorized official:** MRS. NICOLE CAMPBELL (DIRECTOR OF PATIENT ACCESS)
- **Authorized official phone:** (512) 948-1752

## Contact information

- **Practice address:** 8703 BANDERA RD, SAN ANTONIO, TX 78250-2504
- **Practice address phone:** (512) 309-8925
- **Mailing address:** 1464 E WHITESTONE BLVD STE 1101, CEDAR PARK, TX 78613-9070
- **Mailing address phone:** (210) 610-7605
- **Mailing address fax:** (210) 332-5345

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | NULL | Yes |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | — | — | Yes |
| 207PT0002X | Medical Toxicology (Emergency Medicine) Physician | — | NULL | — |
| 207PT0002X | Medical Toxicology (Emergency Medicine) Physician | — | — | — |

## Other

- **Enumeration date:** 09/29/2022
- **Last updated:** 04/19/2024