Provider Demographics
NPI:1104193564
Name:CALDER IMMEDIATE CARE PLLC
Entity Type:Organization
Organization Name:CALDER IMMEDIATE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-852-1550
Mailing Address - Street 1:1108 GULF FWY S
Mailing Address - Street 2:STE 220
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5100
Mailing Address - Country:US
Mailing Address - Phone:281-557-4404
Mailing Address - Fax:281-557-4443
Practice Address - Street 1:1108 GULF FWY S
Practice Address - Street 2:STE 220
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5100
Practice Address - Country:US
Practice Address - Phone:281-557-4404
Practice Address - Fax:281-557-4443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty