Healthcare Provider Details

I. General information

NPI: 1366002172
Provider Name (Legal Business Name): EMCC PADRE ISLAND URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2019
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14433 S PADRE ISLAND DR
CORPUS CHRISTI TX
78418-5938
US

IV. Provider business mailing address

2300 MATLOCK RD STE 35
MANSFIELD TX
76063-5018
US

V. Phone/Fax

Practice location:
  • Phone: 361-949-1900
  • Fax: 361-949-2500
Mailing address:
  • Phone: 469-830-8200
  • Fax: 469-830-8201

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: MICHELLE NEWSOM
Title or Position: PRESIDENT
Credential:
Phone: 469-830-8200