Organization
FASTPASS UCC, PLLC
Active
Parent organization
FASTPASS UCC, PLLC
Other names
Code 3 Urgent Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
FASTPASS UCC, PLLC
Authorized official
CARRIE E DE MOOR MD (AUTHORIZED OFFICIAL; CEO)
(469) 320-9820
Entity
Organization
Contact information
Practice address
12600 ROLATER RD STE 120, FRISCO, TX 75035-5188
(214) 383-7543
(214) 383-7544
Mailing address
5300 TOWN AND COUNTRY BLVD STE 260, FRISCO, TX 75034-6913
(469) 208-5297
(214) 260-0707
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511138
MEDICARE
TX
Enumeration date
04/21/2017
Last updated
01/03/2019
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