Provider Demographics
NPI:1417186230
Name:URGENT CARE INSTITUTE OF ABILENE LLC
Entity Type:Organization
Organization Name:URGENT CARE INSTITUTE OF ABILENE LLC
Other - Org Name:DR J EXPRESS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KANDICE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:WESTFALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-676-1100
Mailing Address - Street 1:PO BOX 6728
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-6728
Mailing Address - Country:US
Mailing Address - Phone:325-676-1100
Mailing Address - Fax:325-676-1106
Practice Address - Street 1:3802 CATCLAW DR
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-8253
Practice Address - Country:US
Practice Address - Phone:325-676-1100
Practice Address - Fax:325-676-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
A73201Medicare UPIN