Provider Demographics
NPI:1598128787
Name:NORMANDY URGENT CARE CENTER PA
Entity Type:Organization
Organization Name:NORMANDY URGENT CARE CENTER PA
Other - Org Name:IMPERIAL VALLEY URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-453-8900
Mailing Address - Street 1:779 NORMANDY ST STE 114
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-3441
Mailing Address - Country:US
Mailing Address - Phone:713-453-8900
Mailing Address - Fax:
Practice Address - Street 1:16272 IMPERIAL VALLEY DR STE K
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3566
Practice Address - Country:US
Practice Address - Phone:281-405-6900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORMANDY URGENT CARE CENTER PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-04-04
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2584208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty