Organization
LUMIN ER CAMP BOWIE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF VANHORN (CEO)
(913) 972-4976
Entity
Organization
Contact information
Practice address
4520 CAMP BOWIE BLVD, FORT WORTH, TX 76107-3837
(913) 972-4976
Mailing address
4520 CAMP BOWIE BLVD, FORT WORTH, TX 76107-3837
(913) 972-4976
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/22/2016
Last updated
03/22/2016
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