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General NPI Number Information
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NPI Number | 1164172300
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS URGENT CARE CENTER PLLC
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 1801 N ED CAREY DR STE A
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City | HARLINGEN
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State | TX
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Zip | 78550-8281
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Country | US
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Telephone | 956-205-1244
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Fax | 956-205-1245
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Provider Business Mailing Address
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Address Line | PO BOX 2669
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City | FRISCO
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State | TX
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Zip | 75034-0050
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Country | US
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Telephone | 855-329-8220
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Fax | 956-205-1245
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT/ CO-OWNER
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Name | MR. FERNANDO VASQUEZ JR.
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Credential | PA-C
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Telephone | 956-205-1244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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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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