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Organization

PROVIDER ON DEMAND LLC

Active
Other names
Provider on Demand, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRETT MARVEL MD (COO)
(737) 747-2200
Entity
Organization

Contact information

Practice address
1199 OLD LORENA RD, LORENA, TX 76655-3176
(757) 642-5062
(737) 270-7540
Mailing address
1551 W CENTRAL AVE, TEMPLE, TX 76504-4005

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
208D00000X
General Practice Physician
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
02/01/2024
Last updated
10/09/2024
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