Provider Demographics
NPI: | 1609370022 |
---|---|
Name: | AWAAM URGENT CARE CLINIC LLC |
Entity Type: | Organization |
Organization Name: | AWAAM URGENT CARE CLINIC LLC |
Other - Org Name: | AWAAM URGENT CARE CLINIC LLC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | NP |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ABDUL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WAHEED |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MSN,FNP,BC |
Authorized Official - Phone: | 832-491-1506 |
Mailing Address - Street 1: | 6108 GULFTON ST |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77081-2304 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 832-491-1506 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 6110 GULFTON ST |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77081-2304 |
Practice Address - Country: | US |
Practice Address - Phone: | 281-857-1608 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2018-03-20 |
Last Update Date: | 2023-02-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |