Provider Demographics
NPI:1841824489
Name:SENIOR CARE PROVIDERS PLLC
Entity type:Organization
Organization Name:SENIOR CARE PROVIDERS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-945-5450
Mailing Address - Street 1:1910 ASPLEY CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-3431
Mailing Address - Country:US
Mailing Address - Phone:484-431-0039
Mailing Address - Fax:
Practice Address - Street 1:6630 FM 1463 RD STE A500
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-7526
Practice Address - Country:US
Practice Address - Phone:346-707-8978
Practice Address - Fax:313-457-1003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-22
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty