Provider Demographics
NPI:1063545622
Name:TEXAS URGENT CARE ASSOCIATES, P.A.
Entity type:Organization
Organization Name:TEXAS URGENT CARE ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE AMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-326-2243
Mailing Address - Street 1:2100 W WILLIAM CANNON DR STE C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-4869
Mailing Address - Country:US
Mailing Address - Phone:512-326-2243
Mailing Address - Fax:512-326-3499
Practice Address - Street 1:2100 W WILLIAM CANNON DR STE C
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-4869
Practice Address - Country:US
Practice Address - Phone:512-326-2243
Practice Address - Fax:512-326-3499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00183NMedicare PIN