MEDICARE: STATCARE GROUP, LLC

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	:	1841772589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STATCARE GROUP, LLC

Provider Business Mailing Address
First Line	:	3711 S MO PAC EXPY
Second Line	:	BLDG 2 STE 400
City	:	AUSTIN
State	:	TX
Zip	:	78746
Country	:	US
Telephone Number	:	512-271-5844
Fax Number	:

Provider Business Practice Location Address
First Line	:	11804 REISTERSTOWN RD
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-3311
Country	:	US
Telephone Number	:	410-753-4841
Fax Number	:

Authorized Official
Title or Position	:	CMO
Name	:	SCOTT THEODORE BURGER
Credential	:
Telephone Number	:	410-296-0018

Provider Enumeration Date	:	08/29/2018
Last Update Date	:	08/29/2018

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Directions to “STATCARE GROUP, LLC ” Practice Location

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