Provider Demographics
NPI:1710664826
Name:FAIRMONT URGENT CARE
Entity Type:Organization
Organization Name:FAIRMONT URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHU
Authorized Official - Middle Name:
Authorized Official - Last Name:SYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-222-7370
Mailing Address - Street 1:4002 BURKE RD STE 700
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-3451
Mailing Address - Country:US
Mailing Address - Phone:346-222-7370
Mailing Address - Fax:281-487-7054
Practice Address - Street 1:400 W FAIRMONT PKWY
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:TX
Practice Address - Zip Code:77571-6308
Practice Address - Country:US
Practice Address - Phone:346-222-7370
Practice Address - Fax:281-487-7054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty