Provider Demographics
NPI:1457131294
Name:URGENT CARE PROVIDERS
Entity Type:Organization
Organization Name:URGENT CARE PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMO, KENT COMPANIES
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA, FACEP
Authorized Official - Phone:432-520-4000
Mailing Address - Street 1:PO BOX 908001
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79708
Mailing Address - Country:US
Mailing Address - Phone:432-520-4000
Mailing Address - Fax:
Practice Address - Street 1:3401 GREENBRIAR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-4652
Practice Address - Country:US
Practice Address - Phone:432-218-5179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty