Healthcare Provider Details

I. General information

NPI: 1841824489
Provider Name (Legal Business Name): SENIOR CARE PROVIDERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2020
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6630 FM 1463 RD STE A500
KATY TX
77494-7526
US

IV. Provider business mailing address

1910 ASPLEY CT
HOUSTON TX
77094-3431
US

V. Phone/Fax

Practice location:
  • Phone: 346-707-8978
  • Fax: 313-457-1003
Mailing address:
  • Phone: 484-431-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOHAMED MANSOUR
Title or Position: OWNER
Credential: MD
Phone: 313-945-5450