Healthcare Provider Details

I. General information

NPI: 1710664826
Provider Name (Legal Business Name): FAIRMONT URGENT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W FAIRMONT PKWY
LA PORTE TX
77571-6308
US

IV. Provider business mailing address

4002 BURKE RD STE 700
PASADENA TX
77504-3451
US

V. Phone/Fax

Practice location:
  • Phone: 346-222-7370
  • Fax: 281-487-7054
Mailing address:
  • Phone: 346-222-7370
  • Fax: 281-487-7054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ASHU SYAL
Title or Position: OWNER & PHYSICIAN
Credential: MD
Phone: 346-222-7370