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NPI Code Detail

MEDICARE: SHERMAN IMMEDIATE CARE CLINIC PLLC

MEDICARE: SHERMAN IMMEDIATE CARE CLINIC PLLC
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
1261QU0200XUrgent Care Clinic/CenterTX

General Provider Information

NPI Number : 1962702431
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERMAN IMMEDIATE CARE CLINIC PLLC
Provider Business Mailing Address
First Line : 913 COTTONWOOD DR
Second Line :
City : SHERMAN
State : TX
Zip : 75090-2831
Country : US
Telephone Number : 903-868-9565
Fax Number :
Provider Business Practice Location Address
First Line : 913 COTTONWOOD DR
Second Line :
City : SHERMAN
State : TX
Zip : 75090-2831
Country : US
Telephone Number : 903-868-9565
Fax Number :
Authorized Official
Title or Position : CLINIC MANAGER
Name : MRS. DONNA J. GAGE
Credential :
Telephone Number : 903-868-9565
Provider Enumeration Date : 10/29/2010
Last Update Date : 06/24/2011

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Directions to “SHERMAN IMMEDIATE CARE CLINIC PLLC ” Practice Location

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