Provider Demographics
NPI:1609330950
Name:MERCY-TEDDY HEALTH CARE LLC
Entity Type:Organization
Organization Name:MERCY-TEDDY HEALTH CARE LLC
Other - Org Name:ZION URGENT CARE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:TEWODROS
Authorized Official - Middle Name:WOLDEMARIAM
Authorized Official - Last Name:TEKETEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-258-7081
Mailing Address - Street 1:29514 HIGHLAND MANOR CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-7778
Mailing Address - Country:US
Mailing Address - Phone:832-447-6454
Mailing Address - Fax:866-237-7319
Practice Address - Street 1:25311 KINGSLAND BLVD STE 190
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7349
Practice Address - Country:US
Practice Address - Phone:832-913-8504
Practice Address - Fax:832-913-8527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-30
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty