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General NPI Number Information
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NPI Number | 1104635754
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Entity Type | Organization
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Legal Business Name | AMC MEDICAL CLINIC GROUP INC.
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 5501 CABRERA DRIVE, UNIT 902
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City | SUGARLAND
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State | TX
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Zip | 77479
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Country | US
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Telephone | 516-851-2458
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Fax |
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Provider Business Mailing Address
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Address Line | 4543 ROYAL BEND LN
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City | SUGAR LAND
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State | TX
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Zip | 77479-1565
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO / MEDICAL DIRECTOR
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Name | ANJU CHACKO
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Credential | MD
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Telephone | 516-851-2458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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