Provider Demographics
NPI:1194367284
Name:FAST CLINIC LLC
Entity Type:Organization
Organization Name:FAST CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:NDEGWA
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:281-679-9500
Mailing Address - Street 1:1398 ELDRIDGE PKWY STE 113
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-2548
Mailing Address - Country:US
Mailing Address - Phone:281-679-9500
Mailing Address - Fax:281-679-9501
Practice Address - Street 1:1398 ELDRIDGE PKWY STE 113
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-2548
Practice Address - Country:US
Practice Address - Phone:281-679-9500
Practice Address - Fax:281-679-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty