Healthcare Provider Details

I. General information

NPI: 1407171077
Provider Name (Legal Business Name): NORMANDY URGENT CARE CENTER PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2010
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

779 NORMANDY ST SUITE-114
HOUSTON TX
77015-0779
US

IV. Provider business mailing address

779 NORMANDY ST SUITE-114
HOUSTON TX
77015-0779
US

V. Phone/Fax

Practice location:
  • Phone: 713-893-6214
  • Fax: 718-640-2713
Mailing address:
  • Phone: 713-453-8900
  • Fax: 713-453-8901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberL2584
License Number StateTX

VIII. Authorized Official

Name: MR. ABDUR RAUF
Title or Position: MEDICAL DOCTOR
Credential: M.D.
Phone: 713-893-6214