Provider Demographics
NPI:1437623527
Name:HAMSHIRE-FANNETT URGENT CARE LLC
Entity Type:Organization
Organization Name:HAMSHIRE-FANNETT URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:409-781-3158
Mailing Address - Street 1:15845 HIGHWAY 124
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77705
Mailing Address - Country:US
Mailing Address - Phone:409-781-3158
Mailing Address - Fax:
Practice Address - Street 1:15845 HWY 124
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-8777
Practice Address - Country:US
Practice Address - Phone:409-781-3158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-11
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care