Provider Demographics
NPI:1063034619
Name:URGENT HEALTH SOLUTIONS NACOGDOCHES
Entity Type:Organization
Organization Name:URGENT HEALTH SOLUTIONS NACOGDOCHES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-465-8860
Mailing Address - Street 1:PO BOX 153120
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75915-3120
Mailing Address - Country:US
Mailing Address - Phone:936-633-2400
Mailing Address - Fax:
Practice Address - Street 1:4909 NORTH ST STE 202
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1808
Practice Address - Country:US
Practice Address - Phone:936-560-9898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-16
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty