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General NPI Number Information
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NPI Number | 1881138758
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Entity Type | Organization
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Legal Business Name | BOLT URGENT CARE AND IMAGING CENTER, LLC
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Dates
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Enumeration Date | 12/13/2016
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 1246 FM 3083 WEST
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City | CONROE
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State | TX
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Zip | 77304
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Country | US
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Telephone | 713-922-6718
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Fax |
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Provider Business Mailing Address
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Address Line | 2257 N LOOP 336 W STE 140368
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City | CONROE
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State | TX
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Zip | 77304-3566
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Country | US
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Telephone | 713-922-6718
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JULIE MCKAY SMART
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Credential |
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Telephone | 713-922-6718
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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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