NPIMap

Organization Active NPI

PVD Urgent Care LLC

Doing business as Full Spectrum Urgent Care at Hardy Oak

  • Urgent Care Clinic/Center
  • San Antonio, TX
National Provider Identifier
1215456645
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PVD URGENT CARE LLC
Doing business as
Full Spectrum Urgent Care at Hardy Oak
Practice address
23511 Hardy Oak Blvd
San Antonio, TX 78258-1928
Phone
(210) 361-3266
Fax
(210) 564-9156
NPI assigned
Sep 18, 2017
Last updated
May 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lisa Van Delden
Title
Coo
Phone
(210) 373-9647

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

23511 Hardy Oak Blvd
San Antonio, TX 78258-1928

Mailing address

PO Box 690804
San Antonio, TX 78269-0804

Other names 1

  • Full Spectrum Urgent Care at Hardy Oak Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lisa.vandelden@spechealth.com Direct Full Spectrum Urgent Care

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171121002782 TX Part B Supplier - Clinic/Group Practice 5991062200 Receives reassigned benefits from 29 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: San Antonio, TX

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2221909Full Spectrum Urgent Care at Hardy Oak23511 Hardy Oak, Ste 101, San Antonio, TX 78258Certificate of waiverApr 25, 2027

National Provider Directory

National Provider Directory

Locations

16403 Huebner Rd
San Antonio, TX 78248
Phone (210) 564-9790

18007 Ih 10 W
San Antonio, TX 78257
Phone (210) 530-1040

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1215456645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 690804",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782690804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23511 HARDY OAK BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782581928",
            "telephone_number": "210-361-3266",
            "fax_number": "210-564-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PVD URGENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "VAN DELDEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "210-373-9647"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisa.vandelden@spechealth.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Full Spectrum Urgent Care",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "23511 Hardy Oak Blvd",
            "city": "San Antonio",
            "state": "TX",
            "country_code": "US",
            "postal_code": "782581928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Full Spectrum Urgent Care at Hardy Oak",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.