Organization Name: | COMMUNITYMED URGENT CARE SYSTEM, LLC |
NPI Number: | 1215359674 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BIRKEN OLSON (CEO) |
Mailing Address: | 3591 Mckinney St Suite 200 Melissa |
State: | TX US |
Postal Code: | 754549571 |
Phone Number: | 9724641611 |
Fax Number: | 9724641611 |
NPI Enumeration Date: | 01/19/2014 |
NPI Last Update Date: | 01/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |