1003935107 NPI number — SOUTH TEXAS URGENT CARE, PLLC

Table of content: SANDRA LEE ROWE PMHNP (NPI 1700362597)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003935107 NPI number — SOUTH TEXAS URGENT CARE, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOUTH TEXAS URGENT CARE, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
NORTH CENTRAL URGENT CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003935107
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19223 STONEHUE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78258-3456
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-490-5911
Provider Business Mailing Address Fax Number:
210-481-2769

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19223 STONEHUE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78258-3456
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-490-5911
Provider Business Practice Location Address Fax Number:
210-481-2769
Provider Enumeration Date:
03/28/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LYNCH
Authorized Official First Name:
MIRANDA
Authorized Official Middle Name:
SUE
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
210-490-5911

Provider Taxonomy Codes

  • Taxonomy code: 261QU0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0036MC . This is a "BCBS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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