Provider on Demand LLC
Organization Active NPI Emergency Medicine Physician · Lorena, TX
NPI 1013770148 · NPPES record last updated Oct 9, 2024
Key facts
- NPI
- 1013770148
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- PROVIDER ON DEMAND LLC
- Practice address
- 1199 Old Lorena Rd
Lorena, TX 76655-3176 - Phone
- (757) 642-5062
- Fax
- (737) 270-7540
- NPI assigned
- Feb 1, 2024
- Organization subpart
- No
Authorized official
- Name
- Dr. Brett Marvel, MD
- Title
- Coo
- Phone
- (737) 747-2200
Practitioners 4
-
Brett Alan Marvel, M.D.
-
Marlene Morales, MD
-
Lorenzo Sanchez, FNP-C
-
Daniel F Akers, DO
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2311286 | Provider on Demand - Lorena Clinic | Certificate of waiver | Sep 18, 2026 |
National Provider Directory
Locations
3809 Atascocita Rd
Humble, TX 77396
3810 Atascocita Rd
Humble, TX 77396
3809 Atascocita Rd
Ste 150
Humble, TX 77396
3811 Atascocita Rd
Humble, TX 77396
3812 Atascocita Rd
Humble, TX 77396
1199 Old Lorena Rd
Lorena, TX 76655
Phone (254) 655-4323
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| General Practice Physician |
208D00000X | |||
| Family Nurse Practitioner |
363LF0000X |
Addresses
Primary practice location
1199 Old Lorena Rd
Lorena, TX 76655-3176
Mailing address
1551 W Central Ave
Temple, TX 76504-4005
Other names
- Provider on Demand, LLC
Other providers in Lorena, TX
- Joshua Hunter Niemeyer
- Jessica Lucille Niles
- Pathways Mobile PT, LLC
- Jonathan G Perkins
- Tina Pricer
- Kelsey Ragan
- Shaquan Shuntay Raglin
- Deborah Fletcher Rainer
- Tangela Sue Ratliff
- Austin Ruppanner
All providers in Lorena, TX · Emergency Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.