Provider Demographics
NPI:1043765514
Name:AMERICAN STAT CARE CENTERS - TEXAS PLLC
Entity Type:Organization
Organization Name:AMERICAN STAT CARE CENTERS - TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ENABE
Authorized Official - Middle Name:
Authorized Official - Last Name:YEMBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:318-614-5953
Mailing Address - Street 1:11750 US HIGHWAY 380
Mailing Address - Street 2:STE. 300
Mailing Address - City:CROSSROADS
Mailing Address - State:TX
Mailing Address - Zip Code:76227-8200
Mailing Address - Country:US
Mailing Address - Phone:940-365-2273
Mailing Address - Fax:940-365-2274
Practice Address - Street 1:11750 US HIGHWAY 380
Practice Address - Street 2:STE. 300
Practice Address - City:CROSSROADS
Practice Address - State:TX
Practice Address - Zip Code:76227-8200
Practice Address - Country:US
Practice Address - Phone:940-365-2273
Practice Address - Fax:940-365-2274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty