NPIMap

Organization Active NPI

22250 Bulverde Cec Fossil Creek LLC

Doing business as Fossil Creek Complete Care

  • Emergency Care Clinic/Center
  • San Antonio, TX
National Provider Identifier
1740603422
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
Legal business name
22250 BULVERDE CEC FOSSIL CREEK LLC
Doing business as
Fossil Creek Complete Care
Practice address
22250 Bulverde Rd
120
San Antonio, TX 78261-3084
Phone
(817) 421-0034
Fax
(817) 421-0036
NPI assigned
Jan 30, 2014
Last updated
Feb 10, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Authorized official

Name
Julie Radley
Title
Coo
Phone
(713) 591-2256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X Primary

Addresses

Primary practice location

22250 Bulverde Rd
120
San Antonio, TX 78261-3084

Mailing address

PO Box 93059
Southlake, TX 76092-1059
Phone (817) 421-0034

Other names 1

  • Fossil Creek Complete Care Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644451200000",
    "number": "1740603422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93059",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921059",
            "telephone_number": "817-421-0034",
            "fax_number": "817-421-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 BULVERDE RD",
            "address_2": "120",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782613084",
            "telephone_number": "817-421-0034",
            "fax_number": "817-421-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "22250 BULVERDE CEC FOSSIL CREEK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A",
        "authorized_official_last_name": "RADLEY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "713-591-2256"
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fossil Creek Complete Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fossil Creek Complete Care",
            "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 Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.