Provider Demographics
NPI:1699118505
Name:ASCENSION EMERGENCY PHYSICIANS LLC
Entity type:Organization
Organization Name:ASCENSION EMERGENCY PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:337-277-6355
Mailing Address - Street 1:PO BOX 226128
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75222-6128
Mailing Address - Country:US
Mailing Address - Phone:877-342-7261
Mailing Address - Fax:833-547-6529
Practice Address - Street 1:1125 W HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-5004
Practice Address - Country:US
Practice Address - Phone:225-647-5000
Practice Address - Fax:843-237-9736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-10
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LADU0968OtherRRMCR