Organization
EMERGENCY ASSOCIATES OF CENTRAL TEXAS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON HARDY (DIRECTOR PROVIDER ENROLLMENT)
(925) 251-6901
Entity
Organization
Contact information
Practice address
2201 S CLEAR CREEK RD, KILLEEN, TX 76549-4110
(865) 693-1000
Mailing address
265 BROOKVIEW CENTRE WAY STE 400, KNOXVILLE, TN 37919-4052
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390309802
—
TX
Enumeration date
08/27/2018
Last updated
02/20/2020
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