Provider Demographics
NPI:1134846165
Name:OPS MEDICAL GROUP LLC
Entity type:Organization
Organization Name:OPS MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:210-396-2732
Mailing Address - Street 1:462 WILDFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:LYTLE
Mailing Address - State:TX
Mailing Address - Zip Code:78052-3955
Mailing Address - Country:US
Mailing Address - Phone:726-800-9802
Mailing Address - Fax:
Practice Address - Street 1:462 WILDFLOWER DR
Practice Address - Street 2:
Practice Address - City:LYTLE
Practice Address - State:TX
Practice Address - Zip Code:78052-3955
Practice Address - Country:US
Practice Address - Phone:726-800-9802
Practice Address - Fax:833-505-2044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care