Provider Demographics
NPI:1104286780
Name:TC JESTER EMERGENCY CENTER, LLC
Entity type:Organization
Organization Name:TC JESTER EMERGENCY CENTER, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DARLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-699-3777
Mailing Address - Street 1:PO BOX 733068
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3068
Mailing Address - Country:US
Mailing Address - Phone:832-699-3777
Mailing Address - Fax:713-966-6972
Practice Address - Street 1:1925 E T C JESTER BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1551
Practice Address - Country:US
Practice Address - Phone:832-742-0072
Practice Address - Fax:281-752-7961
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX160238207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty