Basic Information
| Provider Information | |||||||||
| NPI: | 1841772589 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | STATCARE GROUP, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3711 S MO PAC EXPY | ||||||||
| Address2: | BLDG 2 STE 400 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78746 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122715844 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11804 REISTERSTOWN RD | ||||||||
| Address2: | |||||||||
| City: | REISTERSTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211363311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107534841 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2018 | ||||||||
| LastUpdateDate: | 08/29/2018 | ||||||||
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| AuthorizedOfficialLastName: | BURGER | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
| AuthorizedOfficialMiddleName: | THEODORE | ||||||||
| AuthorizedOfficialTitleorPosition: | CMO | ||||||||
| AuthorizedOfficialTelephone: | 4102960018 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.