MEDICARE: AWAAM URGENTCARE CLINIC & MINOR EMERGENCY

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	:	1376051136
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AWAAM URGENTCARE CLINIC & MINOR EMERGENCY

Provider Business Mailing Address
First Line	:	6110 GULFTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-2304
Country	:	US
Telephone Number	:	281-857-1608
Fax Number	:

Provider Business Practice Location Address
First Line	:	6110 GULFTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-2304
Country	:	US
Telephone Number	:	281-857-1608
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ABDUL WAHEED
Credential	:	MSN
Telephone Number	:	281-857-1608

Provider Enumeration Date	:	01/16/2018
Last Update Date	:	01/16/2018

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