=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730073792
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH TEXAS URGENT CARE, P.A.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2025
-----------------------------------------------------
Last Update Date | 06/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2200 E BROAD ST STE 100
-----------------------------------------------------
City | MANSFIELD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76063-6597
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-473-9473
-----------------------------------------------------
Fax | 817-473-3473
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1669 S 9TH ST STE 100
-----------------------------------------------------
City | MIDLOTHIAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76065-3754
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-473-9473
-----------------------------------------------------
Fax | 214-504-2435
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEDICAL DIRECTOR
-----------------------------------------------------
Name | MINH V. NGUYEN
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 817-473-9473
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------