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Contact Information

LONGEVITY URGENT CARE PLLC
128 WEST MCCART ST
STE B
KRUM, TX76249
 Phone: 940-390-9709
 Fax: 940-482-1775
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Family

363LF0000X 50 Nurse Practitioner
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for LONGEVITY URGENT CARE PLLC · (Female)

NPI Number 1972889988
Status Active
Credentials
Entity Individual
Enumeration date 10/24/2011
Last updated 01/28/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • TX License # 778411
  • TX License # F1170
  • TX License # K7643
  • TX Other 778411 TEXAS BOARD OF NURSING
  • TX Other F1170 TEXAS MEDICAL BOARD LIC. #
  • TX Other K7643 TEXAS MEDICAL BOARD LIC. #
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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