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General NPI Number Information
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NPI Number | 1528297751
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Entity Type | Organization
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Legal Business Name | LUFKIN URGENT CARE PA
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Dates
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Enumeration Date | 07/09/2009
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Last Update Date | 07/09/2009
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Provider Practice Location Address
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Address Line | 710 GASLIGHT BLVD STE B
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City | LUFKIN
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State | TX
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Zip | 75904-3187
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Country | US
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Telephone | 936-632-4042
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Fax | 936-632-0794
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Provider Business Mailing Address
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Address Line | 710 GASLIGHT BLVD STE B
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City | LUFKIN
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State | TX
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Zip | 75904-3187
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Country | US
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Telephone | 936-632-4042
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Fax | 936-632-0794
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ALEXANDER ORLOV
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Credential | DO
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Telephone | 936-632-4042
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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 | J4402
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License Number State | TX
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