Provider Demographics
NPI:1528393840
Name:BELLA TERRA URGENT CARE
Entity Type:Organization
Organization Name:BELLA TERRA URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANEESH
Authorized Official - Middle Name:
Authorized Official - Last Name:MEHRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-331-5685
Mailing Address - Street 1:5530 W GRAND PKWY S
Mailing Address - Street 2:STE # 500
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-5802
Mailing Address - Country:US
Mailing Address - Phone:832-331-5685
Mailing Address - Fax:
Practice Address - Street 1:5530 W GRAND PKWY S
Practice Address - Street 2:STE # 500
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-5802
Practice Address - Country:US
Practice Address - Phone:832-331-5685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDADMIIN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6287207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty