Provider Demographics
NPI:1124387089
Name:WATERSIDE URGENT CARE PARTNERS LP
Entity Type:Organization
Organization Name:WATERSIDE URGENT CARE PARTNERS LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:S
Authorized Official - Last Name:BREEZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-207-2661
Mailing Address - Street 1:16107 KENSINGTON DR
Mailing Address - Street 2:SUITE 126
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4224
Mailing Address - Country:US
Mailing Address - Phone:281-207-2661
Mailing Address - Fax:281-207-2682
Practice Address - Street 1:7790 W GRAND PKWY S
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469
Practice Address - Country:US
Practice Address - Phone:281-207-2661
Practice Address - Fax:281-207-2682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-14
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care