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General NPI Number Information
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NPI Number | 1063741163
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Entity Type | Organization
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Legal Business Name | AZTEC URGENT CARE, LLC
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Dates
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Enumeration Date | 12/18/2009
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 604 S RIO GRANDE AVE
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City | AZTEC
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State | NM
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Zip | 87410-2260
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Country | US
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Telephone | 505-334-2664
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Fax | 505-334-7759
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Provider Business Mailing Address
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Address Line | 2577 MAIN AVE
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City | DURANGO
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State | CO
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Zip | 81301-5919
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Country | US
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Telephone | 970-247-8382
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Fax | 970-259-4403
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRYAN VINCENT
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Credential |
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Telephone | 970-247-8382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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