Provider Demographics
NPI:1043561434
Name:RAYPHA URGENT CARE & CLINICS
Entity Type:Organization
Organization Name:RAYPHA URGENT CARE & CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAKIYA
Authorized Official - Middle Name:ENGO
Authorized Official - Last Name:DIALLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-271-1156
Mailing Address - Street 1:3334 BROADWAY BLVD
Mailing Address - Street 2:422
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-1585
Mailing Address - Country:US
Mailing Address - Phone:972-271-1156
Mailing Address - Fax:972-271-1691
Practice Address - Street 1:3334 BROADWAY BLVD
Practice Address - Street 2:422
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-1585
Practice Address - Country:US
Practice Address - Phone:972-271-1156
Practice Address - Fax:972-271-1691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN4380261QP2300X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care