Provider Demographics
NPI:1144698689
Name:SCHERTZ CIBOLO EMERGENCY CENTER, LLC
Entity type:Organization
Organization Name:SCHERTZ CIBOLO EMERGENCY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:210-909-5700
Mailing Address - Street 1:4825 ROY RICHARD DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154
Mailing Address - Country:US
Mailing Address - Phone:210-202-1123
Mailing Address - Fax:888-604-9219
Practice Address - Street 1:4825 ROY RICHARD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154
Practice Address - Country:US
Practice Address - Phone:210-202-1123
Practice Address - Fax:888-604-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency Care