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Organization
EBD BEMC BURLESON, LLC
Active
Organization
EBD BEMC BURLESON, LLC
Active
Other names
Baylor Scott & White Emergency Hospital Grand Prairie
Organization subpart
No
Provider details
NPI number
Authorized official
TINA JOHNSON (SR PROVIDER ENROLLMENT COORDINATOR)
(713) 929-2076
Entity
Organization
Contact information
Practice address
3095 KINGSWOOD BLVD, SUITE 100, GRAND PRAIRIE, TX 75052
(713) 637-1146
Mailing address
8686 NEW TRAILS DR STE 100, THE WOODLANDS, TX 77381-1176
(713) 637-1146
(281) 298-5311
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
—
NULL
282N00000X
General Acute Care Hospital
Primary
—
NULL
Other
Enumeration date
06/14/2017
Last updated
05/10/2024
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