Healthcare Provider Details

I. General information

NPI: 1104635754
Provider Name (Legal Business Name): AMC MEDICAL CLINIC GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 CABRERA DRIVE, UNIT 902
SUGARLAND TX
77479
US

IV. Provider business mailing address

4543 ROYAL BEND LN
SUGAR LAND TX
77479-1565
US

V. Phone/Fax

Practice location:
  • Phone: 516-851-2458
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANJU CHACKO
Title or Position: CEO / MEDICAL DIRECTOR
Credential: MD
Phone: 516-851-2458