Provider Demographics
NPI:1568696227
Name:DOCTORS EXPRESS OF THE TEMPLE AREA, PA
Entity Type:Organization
Organization Name:DOCTORS EXPRESS OF THE TEMPLE AREA, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYUN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-215-9789
Mailing Address - Street 1:3614 SW HK DODGEN LOOP
Mailing Address - Street 2:SUITE F
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-6806
Mailing Address - Country:US
Mailing Address - Phone:254-295-0117
Mailing Address - Fax:
Practice Address - Street 1:3614 SW HK DODGEN LOOP
Practice Address - Street 2:SUITE F
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504
Practice Address - Country:US
Practice Address - Phone:254-295-0117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care