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General NPI Number Information
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NPI Number | 1356974281
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Entity Type | Organization
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Legal Business Name | UT EAST TEXAS URGENT CARE CENTERS, PLLC
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Dates
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Enumeration Date | 02/19/2020
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 301 E STATE HIGHWAY 243 STE 121
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City | CANTON
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State | TX
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Zip | 75103-2418
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Country | US
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Telephone | 903-567-4692
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Fax |
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Provider Business Mailing Address
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Address Line | 340 SEVEN SPRINGS WAY STE 100
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City | BRENTWOOD
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State | TN
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Zip | 37027-5697
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Country | US
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Telephone | 615-296-3594
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Fax |
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Authorized Official
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Title or Position | EVP, GENERAL COUNSEL
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Name | STEPHEN C. PETROVICH
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Credential |
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Telephone | 615-296-3594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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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 | 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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