Healthcare Provider Details

I. General information

NPI: 1801237581
Provider Name (Legal Business Name): EAGLE FORD URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 03/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

662 10TH ST BUILDING A
FLORESVILLE TX
78114-3186
US

IV. Provider business mailing address

662 10TH ST BUILDING A
FLORESVILLE TX
78114-3186
US

V. Phone/Fax

Practice location:
  • Phone: 210-881-0864
  • Fax: 866-611-6561
Mailing address:
  • Phone: 830-393-3133
  • Fax: 210-333-0775

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: MR. BRIAN JOHNSON
Title or Position: MANAGING PARTNER
Credential: NP
Phone: 210-373-8570