Provider Demographics
NPI:1467844373
Name:MEDPREM URGENT CARE CENTER BUSINESS TR
Entity Type:Organization
Organization Name:MEDPREM URGENT CARE CENTER BUSINESS TR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:OWUSU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-203-9000
Mailing Address - Street 1:3705 N BELT LINE RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-9211
Mailing Address - Country:US
Mailing Address - Phone:469-230-8666
Mailing Address - Fax:
Practice Address - Street 1:3705 N BELT LINE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-9211
Practice Address - Country:US
Practice Address - Phone:469-230-8666
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care