Provider Demographics
NPI:1386689446
Name:TEXAS MIDWEST EXPRESS CARE, P.A.
Entity type:Organization
Organization Name:TEXAS MIDWEST EXPRESS CARE, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:GAYLE
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-690-1500
Mailing Address - Street 1:PO BOX 6728
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-6728
Mailing Address - Country:US
Mailing Address - Phone:325-690-1500
Mailing Address - Fax:325-690-1578
Practice Address - Street 1:4009 RIDGEMONT DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2733
Practice Address - Country:US
Practice Address - Phone:325-690-1500
Practice Address - Fax:325-690-1578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD97460Medicare UPIN
TXS93059Medicare UPIN
TXA73201Medicare UPIN
TXH09984Medicare UPIN
TX00035XMedicare ID - Type UnspecifiedFACILITY ID NUMBER
TXE98925Medicare UPIN