Organization
BRAZOS VALLEY ER, LLC
Active
Other names
Physicians PremiER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JARED SHAHAN MD (LLC MEMBER/MANAGER)
(361) 991-0912
Entity
Organization
Contact information
Practice address
2411 BOONVILLE RD, BRYAN, TX 77808-2231
(979) 775-0911
(512) 825-4625
Mailing address
PO BOX 61041, CORPUS CHRISTI, TX 78466-1041
(361) 884-2904
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/13/2017
Last updated
07/21/2022
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