Provider Demographics
NPI:1578921524
Name:NEXTCARE PRIMARY CARE SOUTH TEXAS PLLC
Entity Type:Organization
Organization Name:NEXTCARE PRIMARY CARE SOUTH TEXAS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF REIMBURSEMENT SERVICIES
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:MARPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-776-1600
Mailing Address - Street 1:1602 E HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:BEEVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78102-5326
Mailing Address - Country:US
Mailing Address - Phone:480-776-1600
Mailing Address - Fax:480-776-1605
Practice Address - Street 1:2550 N THUNDERBIRD CIR
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-1219
Practice Address - Country:US
Practice Address - Phone:480-776-1600
Practice Address - Fax:480-776-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-05
Last Update Date:2016-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty