Provider Demographics
NPI:1881138758
Name:BOLT URGENT CARE AND IMAGING CENTER, LLC
Entity type:Organization
Organization Name:BOLT URGENT CARE AND IMAGING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKAY SMART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-922-6718
Mailing Address - Street 1:2257 N LOOP 336 W STE 140368
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3566
Mailing Address - Country:US
Mailing Address - Phone:713-922-6718
Mailing Address - Fax:
Practice Address - Street 1:1246 FM 3083 WEST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304
Practice Address - Country:US
Practice Address - Phone:713-922-6718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care