Provider Demographics
NPI:1871526442
Name:SOUTH TEXAS URGENT CARE CENTER
Entity type:Organization
Organization Name:SOUTH TEXAS URGENT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHRISTIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-278-1166
Mailing Address - Street 1:3040 E MAIN ST
Mailing Address - Street 2:STE Z
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78801-6403
Mailing Address - Country:US
Mailing Address - Phone:830-278-1166
Mailing Address - Fax:830-278-1223
Practice Address - Street 1:3040 E MAIN ST
Practice Address - Street 2:STE Z
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801-6403
Practice Address - Country:US
Practice Address - Phone:830-278-1166
Practice Address - Fax:830-278-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4254207Q00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00W069Medicare PIN
TXCI4476Medicare UPIN