Healthcare Provider Details

I. General information

NPI: 1679052666
Provider Name (Legal Business Name): ACCESS URGENT CARE-KINGSVILLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E KING AVE
KINGSVILLE TX
78363-5666
US

IV. Provider business mailing address

PO BOX 60112
CORPUS CHRISTI TX
78466-0112
US

V. Phone/Fax

Practice location:
  • Phone: 361-884-2904
  • Fax: 361-884-1912
Mailing address:
  • Phone: 361-884-2904
  • Fax: 361-884-1912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberH8172
License Number StateTX

VIII. Authorized Official

Name: PAUL DAVID KENYON
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 361-884-2904