Healthcare Provider Details

I. General information

NPI: 1588221246
Provider Name (Legal Business Name): SOUTH WEST URGENT CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 S PENN AVE
OKLAHOMA CITY OK
73119-4945
US

IV. Provider business mailing address

4901 S PENN AVE
OKLAHOMA CITY OK
73119-4945
US

V. Phone/Fax

Practice location:
  • Phone: 855-541-2862
  • Fax: 405-716-4808
Mailing address:
  • Phone: 855-541-2862
  • Fax: 495-716-4808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. HAMID MAHMOOD
Title or Position: CEO
Credential: MD
Phone: 855-541-2862