Fastpass Ucr, PLLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

FASTPASS UCR, PLLC

Practice address

400 Enterprise Blvd Ste A120
Rockport, TX 78382-4341

Phone

(361) 529-9401

Fax

(361) 529-9402

NPI assigned

Apr 21, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Carrie E De Moor, MD

Title

Ceo

Phone

(469) 320-9820

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Code 3 Urgent Care at Rockport Doing business as

Locations

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531180800000",
    "number": "1780119263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 TOWN AND COUNTRY BLVD STE 260",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750346913",
            "telephone_number": "469-208-5297",
            "fax_number": "214-260-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ENTERPRISE BLVD STE A120",
            "city": "ROCKPORT",
            "state": "TX",
            "postal_code": "783824341",
            "telephone_number": "361-529-9401",
            "fax_number": "361-529-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FASTPASS UCR, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-21",
        "last_updated": "2018-07-10",
        "status": "A",
        "authorized_official_last_name": "DE MOOR",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-320-9820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "00U9Z8",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "378405002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378405001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Code 3 Urgent Care at Rockport",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rose Ann J Elliot, RPH
• Hillary Cherre Engleman, FNP-C
• Ernest C. Alsop, MD, PA
• Charles Esterlein, D.O.
• Family Medicine of Rockport
• Virginia Gayle Fleming-Randolph, PTA
• Jarod Hamilton Fowler, PHARM.D.
• Kari Marie Francis, RPH
• Nick Giannone, M.D.
• David Gilmore, M.D.

• All providers in Rockport, TX
• Urgent Care Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.