Provider Demographics
NPI:1801237581
Name:EAGLE FORD URGENT CARE LLC
Entity type:Organization
Organization Name:EAGLE FORD URGENT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:210-373-8570
Mailing Address - Street 1:662 10TH ST
Mailing Address - Street 2:BUILDING A
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-3186
Mailing Address - Country:US
Mailing Address - Phone:830-393-3133
Mailing Address - Fax:210-333-0775
Practice Address - Street 1:662 10TH ST
Practice Address - Street 2:BUILDING A
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-3186
Practice Address - Country:US
Practice Address - Phone:210-881-0864
Practice Address - Fax:866-611-6561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care