Healthcare Provider Details

I. General information

NPI: 1386049096
Provider Name (Legal Business Name): TEXAS CHILDREN'S URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2014
Last Update Date: 11/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9727 SPRING GREEN BLVD SUITE 900
KATY TX
77494-4138
US

IV. Provider business mailing address

1919 S BRAESWOOD BLVD
HOUSTON TX
77030-4444
US

V. Phone/Fax

Practice location:
  • Phone: 281-789-6300
  • Fax:
Mailing address:
  • Phone: 281-789-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LAURA VILLAR
Title or Position: PROVIDER RELATIONS REPRESENTATIVE
Credential:
Phone: 832-824-6631