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General NPI Number Information
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NPI Number | 1235449752
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Entity Type | Organization
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Legal Business Name | TRI CITIES URGENT CARE PLLC
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 04/13/2011
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Provider Practice Location Address
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Address Line | 123 S. RANCH HOUSE RD
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City | WILLOW PARK
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State | TX
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Zip | 76008-2649
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Country | US
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Telephone | 817-984-7120
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Fax | 817-984-7121
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Provider Business Mailing Address
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Address Line | 123 S. RANCH HOUSE RD
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City | WILLOW PARK
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State | TX
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Zip | 76008-2649
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Country | US
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Telephone | 817-984-7120
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Fax | 817-984-7121
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Authorized Official
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Title or Position | OWNER
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Name | NADEEM A KHAN
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Credential | M.D.
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Telephone | 817-984-7120
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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 | K8777
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License Number State | TX
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