Provider Demographics
NPI:1700215050
Name:CONCENTRA URGENT CARE
Entity Type:Organization
Organization Name:CONCENTRA URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:BERNADETTE
Authorized Official - Last Name:OLMOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-867-2434
Mailing Address - Street 1:3236 KILGORE PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-1909
Mailing Address - Country:US
Mailing Address - Phone:915-867-2434
Mailing Address - Fax:
Practice Address - Street 1:3236 KILGORE PL
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-1909
Practice Address - Country:US
Practice Address - Phone:915-867-2434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2099951251E00000X, 251K00000X, 261Q00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty