Provider Demographics
NPI:1942726898
Name:TEXAS CHILDREN'S URGENT CARE
Entity Type:Organization
Organization Name:TEXAS CHILDREN'S URGENT CARE
Other - Org Name:TCUC - WESTGATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROVIDER RELATIONS
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-824-6631
Mailing Address - Street 1:8080 N STADIUM DR STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1877
Mailing Address - Country:US
Mailing Address - Phone:832-824-6631
Mailing Address - Fax:
Practice Address - Street 1:4477 S LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1579
Practice Address - Country:US
Practice Address - Phone:832-824-6631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX346553601Medicaid