1396043923 NPI number — PHYSICIANS' URGENT CARE, PLLC

Table of content: (NPI 1396043923)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396043923 NPI number — PHYSICIANS' URGENT CARE, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHYSICIANS' 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:
PHYSICIANS 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:
1396043923
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 W CAMPBELL RD
Provider Second Line Business Mailing Address:
STE. 275
Provider Business Mailing Address City Name:
RICHARDSON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75080-3601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-701-8826
Provider Business Mailing Address Fax Number:
972-503-1051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 COVEY DR
Provider Second Line Business Practice Location Address:
STE. 155
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37067-5602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-701-8826
Provider Business Practice Location Address Fax Number:
972-503-1051
Provider Enumeration Date:
03/07/2011

Additional Information

Authorized Official

Authorized Official Last Name:
BEIER
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
H
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
972-701-8826

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)





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