Provider Demographics
NPI:1366841371
Name:SHEPHERD URGENT CARE
Entity Type:Organization
Organization Name:SHEPHERD URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:CARRUTHERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-694-6390
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76540-0938
Mailing Address - Country:US
Mailing Address - Phone:254-245-9045
Mailing Address - Fax:254-245-9284
Practice Address - Street 1:7929 N SHEPHERD DR
Practice Address - Street 2:SUITE B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-6346
Practice Address - Country:US
Practice Address - Phone:713-694-6390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty