| Longevity Urgent Care Pllc | |
|
128 West Mccart St Ste B Krum TX 76249 | |
| (940) 390-9709 | |
| (940) 482-1775 |
| Full Name | Longevity Urgent Care Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 128 West Mccart St, Krum, Texas |
| Authorized Official Name and Position | Adrian C Jones (NURSE PRACTITIONER) |
| Authorized Official Contact | 9403209709 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Longevity Urgent Care Pllc Po Box 798 Krum TX 76249-0798 Ph: (940) 320-9709 | Longevity Urgent Care Pllc 128 West Mccart St Ste B Krum TX 76249 Ph: (940) 390-9709 |
| NPI Number | 1972889988 |
|---|---|
| Provider Enumeration Date | 10/24/2011 |
| Last Update Date | 01/28/2016 |
| Medicare PECOS PAC ID | 2062688500 |
|---|---|
| Medicare Enrollment ID | O20120104000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972889988 | NPI | - | NPPES |
| F1170 | Other | TX | TEXAS MEDICAL BOARD LIC. # |
| 778411 | Other | TX | TEXAS BOARD OF NURSING |
| K7643 | Other | TX | TEXAS MEDICAL BOARD LIC. # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | K7643 (Texas) | Primary |
| 208D00000X | General Practice | F1170 (Texas) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 778411 (Texas) | Secondary |
| Provider Name | Adrian C Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194812495 PECOS PAC ID: 3971779414 Enrollment ID: I20120104000414 |
Krum Family Healthcare Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 141 W. Mccart St, Krum, TX 76249 Phone: 940-482-6702 Fax: 940-482-9704 |