Provider Demographics
NPI:1255760054
Name:QUALITY ACUTE CARE, PA
Entity type:Organization
Organization Name:QUALITY ACUTE CARE, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:THURMOND
Authorized Official - Last Name:DEDMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-249-9995
Mailing Address - Street 1:1421 S MAIN ST
Mailing Address - Street 2:SUITE #111
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-3321
Mailing Address - Country:US
Mailing Address - Phone:830-249-9995
Mailing Address - Fax:830-249-9868
Practice Address - Street 1:1421 S MAIN ST
Practice Address - Street 2:SUITE #111
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-3321
Practice Address - Country:US
Practice Address - Phone:830-249-9995
Practice Address - Fax:830-249-9868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8182207P00000X
TXPA02389363A00000X
261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342847601Medicaid