Provider Demographics
NPI:1417130063
Name:RAPID CARE CLINIC PA
Entity Type:Organization
Organization Name:RAPID CARE CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-848-4405
Mailing Address - Street 1:PO BOX 1598
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78680-1598
Mailing Address - Country:US
Mailing Address - Phone:512-848-4405
Mailing Address - Fax:512-848-4412
Practice Address - Street 1:2120 N MAYS ST
Practice Address - Street 2:SUITE 450
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-2192
Practice Address - Country:US
Practice Address - Phone:512-848-4405
Practice Address - Fax:512-848-4412
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAPID CARE CLINIC PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-06
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0021NPOtherBCBS