Healthcare Provider Details
I. General information
NPI: 1760871602
Provider Name (Legal Business Name): TOTAL URGENT CARE AND OCCUPATIONAL MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/15/2015
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
314 HIGHWAY 3162
CUT OFF LA
70345-3582
US
IV. Provider business mailing address
PO BOX 679638
DALLAS TX
75267-9638
US
V. Phone/Fax
- Phone: 985-632-1820
- Fax: 225-214-9349
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEVE
SELLARS
Title or Position: PRESIDENT
Credential:
Phone: 225-214-9353