Provider Demographics
NPI:1578161022
Name:HENDRICK HEALTH URGENT CARE
Entity Type:Organization
Organization Name:HENDRICK HEALTH URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REVENUE
Authorized Official - Prefix:
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-239-7190
Mailing Address - Street 1:PO BOX 679619
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-9619
Mailing Address - Country:US
Mailing Address - Phone:225-239-7190
Mailing Address - Fax:
Practice Address - Street 1:820 E AMBLER AVE
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601
Practice Address - Country:US
Practice Address - Phone:325-999-9680
Practice Address - Fax:325-393-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-15
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care