Provider Demographics
NPI:1235835786
Name:ROSENBERG URGENT CARE AND FAMILY PRACTICE
Entity Type:Organization
Organization Name:ROSENBERG URGENT CARE AND FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-639-6808
Mailing Address - Street 1:898 HARLEY GOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-1024
Mailing Address - Country:US
Mailing Address - Phone:936-639-6808
Mailing Address - Fax:737-200-7240
Practice Address - Street 1:3310 1ST ST STE 7
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-5869
Practice Address - Country:US
Practice Address - Phone:936-639-6808
Practice Address - Fax:737-200-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA08543OtherPA LICENSE