Provider Demographics
NPI:1568950442
Name:MONT BELVIEU URGENT AND FAMILY CARE LLC
Entity Type:Organization
Organization Name:MONT BELVIEU URGENT AND FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:281-385-8111
Mailing Address - Street 1:9235 N HIGHWAY 146 STE 2
Mailing Address - Street 2:
Mailing Address - City:MONT BELVIEU
Mailing Address - State:TX
Mailing Address - Zip Code:77523-9503
Mailing Address - Country:US
Mailing Address - Phone:281-385-8111
Mailing Address - Fax:
Practice Address - Street 1:9235 N HIGHWAY 146 STE 2
Practice Address - Street 2:
Practice Address - City:MONT BELVIEU
Practice Address - State:TX
Practice Address - Zip Code:77523-9503
Practice Address - Country:US
Practice Address - Phone:281-385-8111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR5018207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty