Provider Demographics
NPI:1457348328
Name:LAREDO URGENT CAER, PA
Entity Type:Organization
Organization Name:LAREDO URGENT CAER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:NEWTON
Authorized Official - Last Name:LIGHTNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-726-0501
Mailing Address - Street 1:214 JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-9116
Mailing Address - Country:US
Mailing Address - Phone:956-795-0433
Mailing Address - Fax:
Practice Address - Street 1:7807 MCPHERSON AVE
Practice Address - Street 2:STE 2E
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78045-2801
Practice Address - Country:US
Practice Address - Phone:956-726-0501
Practice Address - Fax:956-726-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4161261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8B3620Medicare ID - Type Unspecified
TXB24392Medicare UPIN