Provider Demographics
NPI:1861816852
Name:FAMILY WALK-IN CLINIC CORP
Entity Type:Organization
Organization Name:FAMILY WALK-IN CLINIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NAJMEH
Authorized Official - Middle Name:
Authorized Official - Last Name:POURSAEIDIMAHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-413-6985
Mailing Address - Street 1:11814 NEWPORT SHORE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3991
Mailing Address - Country:US
Mailing Address - Phone:281-413-6985
Mailing Address - Fax:713-896-0207
Practice Address - Street 1:6421 W SAM HOUSTON PKWY N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-5102
Practice Address - Country:US
Practice Address - Phone:281-413-6985
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty