Provider Demographics
NPI:1205698222
Name:TEXAS INJURY CARE LLC
Entity type:Organization
Organization Name:TEXAS INJURY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:F
Authorized Official - Last Name:PEDRAZA-LONGORIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-237-5845
Mailing Address - Street 1:4201 MEDICAL DR STE 140
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5656
Mailing Address - Country:US
Mailing Address - Phone:210-334-0007
Mailing Address - Fax:
Practice Address - Street 1:4201 MEDICAL DR STE 140
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5656
Practice Address - Country:US
Practice Address - Phone:210-334-0007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center