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General NPI Number Information
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NPI Number | 1225433519
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Entity Type | Organization
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Legal Business Name | GRAND PARKWAY URGENT CLINIC LLC
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Dates
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Enumeration Date | 10/29/2014
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Last Update Date | 10/29/2014
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Provider Practice Location Address
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Address Line | 403 W GRAND PKWY S SUITE A
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City | KATY
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State | TX
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Zip | 77494-8358
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Country | US
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Telephone | 713-785-1119
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Fax |
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Provider Business Mailing Address
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Address Line | 403 W GRAND PKWY S SUITE A
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City | KATY
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State | TX
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Zip | 77494-8358
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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 | CONSULTANT
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Name | BENJAMIN ISKHAKOV
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Credential |
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Telephone | 718-480-6700
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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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