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General NPI Number Information
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NPI Number | 1407224850
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Entity Type | Organization
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Legal Business Name | CD URGENT CARE CENTER 5, PLLC
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 09/02/2015
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Provider Practice Location Address
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Address Line | 3020 W 7TH ST SUITE 210
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City | FORT WORTH
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State | TX
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Zip | 76107-9202
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Country | US
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Telephone | 214-871-7000
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Fax | 214-871-7020
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Provider Business Mailing Address
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Address Line | 2807 ALLEN ST PMB 420
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City | DALLAS
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State | TX
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Zip | 75204-1031
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Country | US
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Telephone | 214-871-7000
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Fax | 214-871-7020
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. BRENNA J NANCE
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Credential | M.D.
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Telephone | 214-404-1958
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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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