Provider Demographics
NPI:1861752024
Name:1ST CLASS URGENT CARE CENTER PLLC
Entity type:Organization
Organization Name:1ST CLASS URGENT CARE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:B
Authorized Official - Last Name:TAIWO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-383-1700
Mailing Address - Street 1:PO BOX 1485
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-0024
Mailing Address - Country:US
Mailing Address - Phone:214-383-1700
Mailing Address - Fax:
Practice Address - Street 1:1811 E BETHANY DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-1882
Practice Address - Country:US
Practice Address - Phone:214-383-1700
Practice Address - Fax:214-383-7166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0026XVOtherBCBS OF TEXAS
TX0026XVOtherBCBS OF TEXAS