Provider Demographics
NPI:1831645415
Name:EMINENT MEDICAL CENTER OPERATING LLC
Entity type:Organization
Organization Name:EMINENT MEDICAL CENTER OPERATING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GENRKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-910-8800
Mailing Address - Street 1:1351 W. PRESIDENT GEORGE BUSH HWY.
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:469-910-8800
Mailing Address - Fax:469-910-8801
Practice Address - Street 1:1351 W. PRESIDENT GEORGE BUSH HWY.
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:817-466-9333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No284300000XHospitalsSpecial Hospital