Provider Demographics
NPI:1275905341
Name:PA CAPT SCOTT PLLC
Entity Type:Organization
Organization Name:PA CAPT SCOTT PLLC
Other - Org Name:FAST-TEX URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:210-286-7799
Mailing Address - Street 1:791 FM 1103
Mailing Address - Street 2:STE 125
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-3672
Mailing Address - Country:US
Mailing Address - Phone:210-888-1175
Mailing Address - Fax:
Practice Address - Street 1:791 FM 1103
Practice Address - Street 2:SUITE 125
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108
Practice Address - Country:US
Practice Address - Phone:210-888-1175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-28
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care