Provider Demographics
NPI:1699222497
Name:HASLET URGENT CARE, PLLC
Entity Type:Organization
Organization Name:HASLET URGENT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-209-4110
Mailing Address - Street 1:1116 BOURLAND RD
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3929
Mailing Address - Country:US
Mailing Address - Phone:817-209-4110
Mailing Address - Fax:
Practice Address - Street 1:2432 AVONDALE HASLET RD
Practice Address - Street 2:SUITE 100
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3427
Practice Address - Country:US
Practice Address - Phone:817-992-0748
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care