Provider Demographics
NPI:1013094168
Name:RAPIDCARE CLINIC PA
Entity Type:Organization
Organization Name:RAPIDCARE CLINIC PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-259-1433
Mailing Address - Street 1:PO BOX 1598
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78680
Mailing Address - Country:US
Mailing Address - Phone:512-259-1433
Mailing Address - Fax:512-259-1433
Practice Address - Street 1:902 CRYSTAL FALLS PKWY
Practice Address - Street 2:SUITE 1
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3646
Practice Address - Country:US
Practice Address - Phone:512-259-1433
Practice Address - Fax:512-259-1433
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAPIDCARE CLINIC PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-01
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207Q00000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0021NPOtherBCBS