Healthcare Provider Details

I. General information

NPI: 1326433376
Provider Name (Legal Business Name): COMMUNITY URGENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2015
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6407 S COOPER ST STE 117
ARLINGTON TX
76001-5813
US

IV. Provider business mailing address

PO BOX 941805
PLANO TX
75094-1805
US

V. Phone/Fax

Practice location:
  • Phone: 817-472-7601
  • Fax:
Mailing address:
  • Phone: 469-482-0861
  • Fax: 469-273-1720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AHMED SHUJA
Title or Position: MANAGING MEMBER
Credential:
Phone: 214-506-1136