Organization
CODE 3 EMERGENCY PHYSICIANS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARRIE E DE MOOR MD (CEO)
(469) 320-9820
Entity
Organization
Contact information
Practice address
400 ENTERPRISE BLVD STE A100, ROCKPORT, TX 78382
(361) 529-9400
(361) 529-9402
Mailing address
4701 PAXTON LN, FRISCO, TX 75034-2209
(469) 815-4142
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G6G8
BCBS
TX
Enumeration date
06/24/2014
Last updated
09/08/2022
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