Provider Demographics
NPI:1972038503
Name:JASPER COUNTY URGENT CARE PLLC
Entity Type:Organization
Organization Name:JASPER COUNTY URGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACKLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-550-4198
Mailing Address - Street 1:494 SPRINGHILL ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-4922
Mailing Address - Country:US
Mailing Address - Phone:409-224-3586
Mailing Address - Fax:409-224-3637
Practice Address - Street 1:494 SPRINGHILL ST
Practice Address - Street 2:SUITE 100
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4922
Practice Address - Country:US
Practice Address - Phone:409-224-3586
Practice Address - Fax:409-224-3637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-20
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care