Provider Demographics
NPI:1780911651
Name:IMPACT URGENT CARE
Entity type:Organization
Organization Name:IMPACT URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-493-4357
Mailing Address - Street 1:16403 HUEBNER RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1683
Mailing Address - Country:US
Mailing Address - Phone:210-493-4357
Mailing Address - Fax:210-493-4355
Practice Address - Street 1:16403 HUEBNER RD STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-1683
Practice Address - Country:US
Practice Address - Phone:210-493-4357
Practice Address - Fax:210-493-4355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-12
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1780911651Medicare PIN