Provider Demographics
NPI:1780673319
Name:LITTLE SPURS PEDIATRIC URGENT CARE, PLLC
Entity Type:Organization
Organization Name:LITTLE SPURS PEDIATRIC URGENT CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEZEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-281-8669
Mailing Address - Street 1:14100 SAN PEDRO AVE STE 608
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4363
Mailing Address - Country:US
Mailing Address - Phone:210-281-8669
Mailing Address - Fax:210-314-5044
Practice Address - Street 1:11398 BANDERA RD
Practice Address - Street 2:STE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-6840
Practice Address - Country:US
Practice Address - Phone:210-543-7334
Practice Address - Fax:210-314-5044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-17
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173688608Medicaid
TX00961YMedicare PIN