Provider Demographics
NPI:1730660879
Name:SEALY URGENT CARE CENTER P.A.
Entity Type:Organization
Organization Name:SEALY URGENT CARE CENTER P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KANNAPPAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISHNASWAMY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-701-9576
Mailing Address - Street 1:1036 N CIRCLE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SEALY
Mailing Address - State:TX
Mailing Address - Zip Code:77474-3336
Mailing Address - Country:US
Mailing Address - Phone:979-627-6224
Mailing Address - Fax:
Practice Address - Street 1:1036 N CIRCLE DR STE 101
Practice Address - Street 2:
Practice Address - City:SEALY
Practice Address - State:TX
Practice Address - Zip Code:77474-3336
Practice Address - Country:US
Practice Address - Phone:979-627-6224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care