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General NPI Number Information
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NPI Number | 1922495951
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Entity Type | Organization
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Legal Business Name | VITAL MED URGENT CARE LLC
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 5711 MCPHERSON RD STE 103
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City | LAREDO
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State | TX
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Zip | 78041-6838
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Country | US
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Telephone | 956-602-8595
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Fax | 956-602-8685
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Provider Business Mailing Address
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Address Line | 5711 MCPHERSON RD STE 103
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City | LAREDO
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State | TX
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Zip | 78041-6838
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Country | US
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Telephone | 956-602-8595
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Fax | 956-602-8685
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Authorized Official
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Title or Position | M.D.
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Name | GILBERTO GARZA LOZANO
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Credential | M.D.
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Telephone | 956-602-8595
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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 | M7208
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License Number State | TX
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