# CEC SOUTHLAKE ER PHYSICIANS PLLC

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

## Provider details

- **NPI number:** 1790192532
- **Authorized official:** JOHN NEIMAN ESQ. (GENERAL COUNSEL)
- **Authorized official phone:** (817) 421-0034

## Contact information

- **Practice address:** 321 W SOUTHLAKE BLVD STE 140, SOUTHLAKE, TX 76092-6186
- **Practice address phone:** (817) 421-0034
- **Practice address fax:** (817) 421-0036
- **Mailing address:** PO BOX 93866, SOUTHLAKE, TX 76092-0118
- **Mailing address phone:** (817) 421-0034
- **Mailing address fax:** (817) 421-0036

## Taxonomy

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

## Other

- **Enumeration date:** 07/14/2014
- **Last updated:** 07/14/2014