Organization
USA EMERGENCY CENTERS - CLEAR LAKE, LLC
Active
Other names
Physicians PremiER, Ally Medical Emergency Room Clear Lake, Ally Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JARED T SHAHAN MD (GOVERNING BOARD MEMBER)
(512) 451-0911
Entity
Organization
Contact information
Practice address
3351 CLEAR LAKE CITY BLVD STE 100, HOUSTON, TX 77059-2513
(281) 280-0911
Mailing address
5525 BURNET RD STE A, AUSTIN, TX 78756-1646
(512) 451-0911
(281) 280-0026
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
160329
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160329
FREESTANDING EMERGENCY CENTER LICENSE
TX
Enumeration date
08/12/2017
Last updated
03/22/2024
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