Provider Demographics
NPI:1831485119
Name:NEW CANEY URGENT CARE CENTER, PA
Entity Type:Organization
Organization Name:NEW CANEY URGENT CARE CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:G
Authorized Official - Last Name:WILLENS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-569-0045
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:NEW CANEY
Mailing Address - State:TX
Mailing Address - Zip Code:77357-0309
Mailing Address - Country:US
Mailing Address - Phone:713-569-0045
Mailing Address - Fax:281-399-5677
Practice Address - Street 1:20185 US HIGHWAY 59
Practice Address - Street 2:SUITE 76
Practice Address - City:NEW CANEY
Practice Address - State:TX
Practice Address - Zip Code:77357-8358
Practice Address - Country:US
Practice Address - Phone:713-569-0045
Practice Address - Fax:281-399-5677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9676261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care