Provider Demographics
NPI:1194963017
Name:WESTFIELD URGENT CARE PA
Entity type:Organization
Organization Name:WESTFIELD URGENT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:D
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FAEP
Authorized Official - Phone:281-821-8200
Mailing Address - Street 1:2010 F. M. 1960 RD EAST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-2404
Mailing Address - Country:US
Mailing Address - Phone:281-821-8200
Mailing Address - Fax:281-821-3692
Practice Address - Street 1:2010 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-2404
Practice Address - Country:US
Practice Address - Phone:281-821-8200
Practice Address - Fax:281-821-3692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-30
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6188261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE28647Medicare UPIN