Provider Demographics
NPI:1619535796
Name:PEDIATRIC URGENT CARE OF DENTON, LP
Entity Type:Organization
Organization Name:PEDIATRIC URGENT CARE OF DENTON, LP
Other - Org Name:JUST 4 KIDS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROEMSEN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:940-514-9543
Mailing Address - Street 1:2215 S LOOP 288 STE 322
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4984
Mailing Address - Country:US
Mailing Address - Phone:817-750-7334
Mailing Address - Fax:940-320-1403
Practice Address - Street 1:2215 S LOOP 288 STE 322
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4984
Practice Address - Country:US
Practice Address - Phone:817-750-7334
Practice Address - Fax:940-320-1403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty