MEDICARE: PRIMEAXIS URGENT CARE CENTER-SHADOW CREEK

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	:	1376498964
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMEAXIS URGENT CARE CENTER-SHADOW CREEK

Provider Business Mailing Address
First Line	:	428 SW 27TH AVE APT 212
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33312-2280
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11901 SHADOW CREEK PKWY STE 111
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7346
Country	:	US
Telephone Number	:	469-677-9787
Fax Number	:	281-697-7402

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	MR. STEPHEN PAULSON
Credential	:	MD
Telephone Number	:	954-669-0401

Provider Enumeration Date	:	02/28/2026
Last Update Date	:	03/17/2026

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