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General NPI Number Information
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NPI Number | 1275070708
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Entity Type | Organization
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Legal Business Name | SUGAR LAND WALK-IN CLINIC
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Dates
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Enumeration Date | 01/23/2017
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Last Update Date | 09/25/2017
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Provider Practice Location Address
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Address Line | 1005 SUGARLAND DR
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City | SHERIDAN
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State | WY
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Zip | 82801
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Country | US
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Telephone | 307-751-2765
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Fax |
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Provider Business Mailing Address
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Address Line | 2007 SUMMIT DR
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City | SHERIDAN
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State | WY
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Zip | 82801-4534
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Country | US
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Telephone | 307-751-2765
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | IRVING ROBINSON
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Credential | M.D.
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Telephone | 307-751-2765
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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 | 5548A
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License Number State | WY
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