Provider Demographics
NPI:1407224850
Name:CD URGENT CARE CENTER 5, PLLC
Entity Type:Organization
Organization Name:CD URGENT CARE CENTER 5, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:NANCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-404-1958
Mailing Address - Street 1:2807 ALLEN ST
Mailing Address - Street 2:PMB 420
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1031
Mailing Address - Country:US
Mailing Address - Phone:214-871-7000
Mailing Address - Fax:214-871-7020
Practice Address - Street 1:3020 W 7TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-9202
Practice Address - Country:US
Practice Address - Phone:214-871-7000
Practice Address - Fax:214-871-7020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care