Provider Demographics
NPI:1609115997
Name:TRI-CITY EXPRESS CARE, PLLC
Entity Type:Organization
Organization Name:TRI-CITY EXPRESS CARE, PLLC
Other - Org Name:FASTMED URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-545-2787
Mailing Address - Street 1:890 W ELLIOT RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-5102
Mailing Address - Country:US
Mailing Address - Phone:480-545-2787
Mailing Address - Fax:480-545-1434
Practice Address - Street 1:3131 E THUNDERBIRD RD
Practice Address - Street 2:SUITE 73
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-5600
Practice Address - Country:US
Practice Address - Phone:623-123-4567
Practice Address - Fax:623-345-6789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty