MEDICARE: CONVENIENT URGENT CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1184053225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONVENIENT URGENT CARE LLC

Provider Business Mailing Address
First Line	:	411 W PARKER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-3202
Country	:	US
Telephone Number	:	713-691-3300
Fax Number	:	713-691-3302

Provider Business Practice Location Address
First Line	:	4414 NORTH FWY
Second Line	:	SUITE 800
City	:	HOUSTON
State	:	TX
Zip	:	77022-3654
Country	:	US
Telephone Number	:	713-691-3300
Fax Number	:	713-691-3302

Authorized Official
Title or Position	:	PARTNER/OFFICE MANAGER
Name	:	AIJAZ SYED
Credential	:
Telephone Number	:	713-691-3300

Provider Enumeration Date	:	11/08/2013
Last Update Date	:	11/08/2013

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