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Organization
BACLIFF URGENT CARE, INC
Active
Organization
BACLIFF URGENT CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY DON WILSON PA-C (OWNER/ PRESIDENT)
(281) 222-3951
Entity
Organization
Contact information
Practice address
1136 GRAND AVE, BACLIFF, TX 77518-2760
(281) 339-5018
(281) 339-5098
Mailing address
2826 FOREST HILLS DR, LEAGUE CITY, TX 77573-5750
(281) 334-6328
(281) 538-1715
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA00742
LICENSE
TX
Enumeration date
08/12/2005
Last updated
08/22/2020
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