Provider Demographics
NPI:1447205091
Name:QUALITY CARE PLUS, LLC
Entity Type:Organization
Organization Name:QUALITY CARE PLUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:936-336-3616
Mailing Address - Street 1:2718A N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:TX
Mailing Address - Zip Code:77575-3909
Mailing Address - Country:US
Mailing Address - Phone:936-336-3616
Mailing Address - Fax:
Practice Address - Street 1:2718A N MAIN ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:TX
Practice Address - Zip Code:77575-3909
Practice Address - Country:US
Practice Address - Phone:936-336-3616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W525Medicare PIN