Provider Demographics
NPI:1417101171
Name:CENTRAL TEXAS URGENT CARE P.A.
Entity Type:Organization
Organization Name:CENTRAL TEXAS URGENT CARE P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FOY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:DARK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:254-666-3627
Mailing Address - Street 1:1201 HEWITT DR
Mailing Address - Street 2:203
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-8833
Mailing Address - Country:US
Mailing Address - Phone:254-666-3627
Mailing Address - Fax:
Practice Address - Street 1:1201 HEWITT DR
Practice Address - Street 2:203
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-8833
Practice Address - Country:US
Practice Address - Phone:254-666-3627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2082207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty