Provider Demographics
NPI:1124551833
Name:XPRESS URGENT CARE PC
Entity Type:Organization
Organization Name:XPRESS URGENT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWENR
Authorized Official - Prefix:
Authorized Official - First Name:WAYEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KATRIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-565-3365
Mailing Address - Street 1:49237 FOX DR N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-5205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:49237 FOX DR N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-5205
Practice Address - Country:US
Practice Address - Phone:810-771-4818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty