Provider Demographics
NPI:1447771928
Name:FAMILY PRACTICE & URGENT CARE PA
Entity Type:Organization
Organization Name:FAMILY PRACTICE & URGENT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTARTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HUMAIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-204-8879
Mailing Address - Street 1:10501 GATEWAY BLVD W STE 105
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7929
Mailing Address - Country:US
Mailing Address - Phone:915-307-2371
Mailing Address - Fax:915-307-2383
Practice Address - Street 1:10501 GATEWAY BLVD W STE 105
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7929
Practice Address - Country:US
Practice Address - Phone:915-307-2371
Practice Address - Fax:915-307-2383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty