MEDICARE: EXPRESS URGENT CARE, PC

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		AZ

General Provider Information

NPI Number	:	1750664231
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXPRESS URGENT CARE, PC

Provider Business Mailing Address
First Line	:	10249 W THUNDERBIRD BLVD
Second Line	:	STE. 300
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3113
Country	:	US
Telephone Number	:	623-889-7285
Fax Number	:	623-889-7286

Provider Business Practice Location Address
First Line	:	10249 W THUNDERBIRD BLVD
Second Line	:	STE. 300
City	:	SUN CITY
State	:	AZ
Zip	:	85351-3113
Country	:	US
Telephone Number	:	623-889-7285
Fax Number	:	623-889-7286

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JALAL ABBAS
Credential	:	M.D.
Telephone Number	:	623-815-3757

Provider Enumeration Date	:	09/21/2011
Last Update Date	:	09/21/2011

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