Provider Demographics
NPI:1164889549
Name:CALVARY URGENT CARE PA
Entity Type:Organization
Organization Name:CALVARY URGENT CARE PA
Other - Org Name:CALVARY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-659-2355
Mailing Address - Street 1:108 S WILLIAM BARNETT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4542
Mailing Address - Country:US
Mailing Address - Phone:281-659-2355
Mailing Address - Fax:281-592-1570
Practice Address - Street 1:8484 WILL CLAYTON PKWY
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5830
Practice Address - Country:US
Practice Address - Phone:832-680-2273
Practice Address - Fax:832-995-5219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-15
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty