Healthcare Provider Details

I. General information

NPI: 1861990855
Provider Name (Legal Business Name): XPRESS CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3507 SUNSET DR
FLINT MI
48503-2365
US

IV. Provider business mailing address

3507 SUNSET DR
FLINT MI
48503-2365
US

V. Phone/Fax

Practice location:
  • Phone: 407-620-3003
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED MANSOUR
Title or Position: OWNER/PHYSICIAN
Credential:
Phone: 407-620-3003