Organization
E-DOC URGENT CARE CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRINIVAS GURRAM REDDY (PRESIDENT)
(817) 808-3443
Entity
Organization
Contact information
Practice address
651 N DENTON TAP RD, SUITE 100, COPPELL, TX 75019-2007
(817) 332-6644
(817) 887-5522
Mailing address
2810 BROOKSHIRE DR, SOUTHLAKE, SOUTHLAKE, TX 76092-8933
(817) 332-6644
(817) 887-5522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
10/05/2012
Last updated
10/05/2012
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