MEDICARE: NUCH OF TEXAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1356861470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUCH OF TEXAS

Provider Business Mailing Address
First Line	:	115 EASTPARK DR
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-7548
Country	:	US
Telephone Number	:	615-600-4073
Fax Number	:	615-309-8341

Provider Business Practice Location Address
First Line	:	10765 KENWORTHY ST STE A
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-1748
Country	:	US
Telephone Number	:	915-320-4021
Fax Number	:	915-320-4031

Authorized Official
Title or Position	:	AUTHORIZED SIGNATORY
Name	:	MR. ERIC ENDERLE
Credential	:
Telephone Number	:	615-600-4102

Provider Enumeration Date	:	06/20/2017
Last Update Date	:	06/20/2017

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Directions to “NUCH OF TEXAS ” Practice Location

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