MEDICARE: QV URGENT CARE TX PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1013633700
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QV URGENT CARE TX PLLC

Provider Business Mailing Address
First Line	:	PO BOX 1022
Second Line	:
City	:	WAYNESBORO
State	:	TN
Zip	:	38485-1022
Country	:	US
Telephone Number	:	931-722-2369
Fax Number	:

Provider Business Practice Location Address
First Line	:	1704 LIVE OAK ST
Second Line	:
City	:	COMMERCE
State	:	TX
Zip	:	75428-2552
Country	:	US
Telephone Number	:	430-562-8272
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD REAMS POWERS JR.
Credential	:	MD
Telephone Number	:	931-540-4210

Provider Enumeration Date	:	10/14/2022
Last Update Date	:	10/14/2022

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