Provider Demographics
NPI:1578255311
Name:COMPLETE COMMUNITY CARE PLLC
Entity Type:Organization
Organization Name:COMPLETE COMMUNITY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SALMAN
Authorized Official - Middle Name:RASHEED
Authorized Official - Last Name:MALLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-273-3000
Mailing Address - Street 1:8002 FM 1464 RD STE 300
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-8087
Mailing Address - Country:US
Mailing Address - Phone:832-400-2733
Mailing Address - Fax:832-400-2734
Practice Address - Street 1:8002 FM 1464 RD STE 300
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-8087
Practice Address - Country:US
Practice Address - Phone:209-432-5576
Practice Address - Fax:832-400-2734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care