OrganizationActive
Provider on Demand LLC
NPI 1013770148 · Emergency Medicine Physician · Lorena, TX
Provider details
- NPI number
- 1013770148
- Entity type
- Organization
- Primary specialty
- Emergency Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Brett Marvel, Coo(737) 747-2200
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- General Practice Physician208D00000X
Allopathic & Osteopathic Physicians
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1199 Old Lorena Rd
Lorena, TX 76655-3176
Phone: (757) 642-5062
Fax: (737) 270-7540
Approximate (ZIP-level) locationGet directions
Mailing address
1551 W Central Ave
Temple, TX 76504-4005
Other names (DBA / former)
- Doing business as
- Provider on Demand, LLC
Registry dates
- Enumerated
- 2024-02-01
- Last updated
- 2024-10-09
- Certified
- 2024-10-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.