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General NPI Number Information
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NPI Number | 1629554548
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Entity Type | Organization
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Legal Business Name | QUIKCARE URGENT CARE LLC
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Dates
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Enumeration Date | 07/13/2018
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | 12485 TIMBERLAND BLVD
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City | FORT WORTH
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State | TX
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Zip | 76244-5598
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Country | US
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Telephone | 469-432-2950
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Fax |
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Provider Business Mailing Address
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Address Line | 3540 E BROAD ST STE 120
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City | MANSFIELD
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State | TX
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Zip | 76063-5633
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Country | US
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Telephone | 469-432-2950
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MR. FRED JOHNSON
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Credential |
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Telephone | 248-854-1475
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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 | TX
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