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General NPI Number Information
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NPI Number | 1376090472
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Entity Type | Organization
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Legal Business Name | TEXACARE URGENT CARE, PLLC
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Dates
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Enumeration Date | 09/06/2016
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 3107 GREENE AVE STE 1
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City | FORT WORTH
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State | TX
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Zip | 76109-2319
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Country | US
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Telephone | 803-979-4903
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 721561
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City | NORMAN
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State | OK
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Zip | 73070-8201
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Country | US
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Telephone | 877-485-4474
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Fax | 405-844-1794
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Authorized Official
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Title or Position | PARTNER/AUTHORIZED OFFICIAL
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Name | SHANE PARKER COLE
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Credential | MD
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Telephone | 877-485-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency 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 | 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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