Provider Demographics
NPI:1407171077
Name:NORMANDY URGENT CARE CENTER PA
Entity Type:Organization
Organization Name:NORMANDY URGENT CARE CENTER PA
Other - Org Name:IMPERIAL VALLEY URGENT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDUR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-893-6214
Mailing Address - Street 1:779 NORMANDY ST
Mailing Address - Street 2:SUITE-114
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-0779
Mailing Address - Country:US
Mailing Address - Phone:713-453-8900
Mailing Address - Fax:713-453-8901
Practice Address - Street 1:779 NORMANDY ST
Practice Address - Street 2:SUITE-114
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-0779
Practice Address - Country:US
Practice Address - Phone:713-893-6214
Practice Address - Fax:718-640-2713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-07
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2584208D00000X
261Q00000X, 261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty