Provider Demographics
NPI:1366002172
Name:EMCC PADRE ISLAND URGENT CARE LLC
Entity Type:Organization
Organization Name:EMCC PADRE ISLAND URGENT CARE LLC
Other - Org Name:SUREPOINT URGENT CARE PADRE ISLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-830-8200
Mailing Address - Street 1:2300 MATLOCK RD STE 35
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5018
Mailing Address - Country:US
Mailing Address - Phone:469-830-8200
Mailing Address - Fax:469-830-8201
Practice Address - Street 1:14433 S PADRE ISLAND DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78418-5938
Practice Address - Country:US
Practice Address - Phone:361-949-1900
Practice Address - Fax:361-949-2500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care