Provider Demographics
NPI:1447544986
Name:NEW CANEY MINOR EMERGENCY CLINIC, P.A.
Entity type:Organization
Organization Name:NEW CANEY MINOR EMERGENCY CLINIC, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:WILLENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-569-0045
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-0129
Mailing Address - Country:US
Mailing Address - Phone:713-569-0045
Mailing Address - Fax:281-399-5677
Practice Address - Street 1:20185 US HIGHWAY 59
Practice Address - Street 2:SUITE 74
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-8358
Practice Address - Country:US
Practice Address - Phone:713-569-0045
Practice Address - Fax:281-399-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-01
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9676261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care