Healthcare Provider Details
I. General information
NPI: 1215330501
Provider Name (Legal Business Name): COLUMBUS URGENT CARE PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/01/2014
Last Update Date: 08/02/2022
Certification Date: 08/02/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
926 WALNUT ST
COLUMBUS TX
78934-2215
US
IV. Provider business mailing address
926 WALNUT ST
COLUMBUS TX
78934-2215
US
V. Phone/Fax
- Phone: 713-893-4773
- Fax: 800-708-5070
- Phone: 713-893-6214
- Fax: 718-640-2713
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ABDUR
RAUF
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 713-893-6214