Healthcare Provider Details

I. General information

NPI: 1356878169
Provider Name (Legal Business Name): SABINE URGENT II, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2017
Last Update Date: 05/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E FERTITTA BLVD SUITE B
LEESVILLE LA
71446-4737
US

IV. Provider business mailing address

PO BOX 130
NEW LLANO LA
71461-0130
US

V. Phone/Fax

Practice location:
  • Phone: 337-239-2207
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CROWE
Title or Position: PHYSICIAN
Credential: MD
Phone: 337-239-2207