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General NPI Number Information
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NPI Number | 1366925240
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Entity Type | Organization
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Legal Business Name | ICARE CLINIC PLLC
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 13333 DOTSON RD STE 140
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City | HOUSTON
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State | TX
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Zip | 77070-4305
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Country | US
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Telephone | 281-890-6800
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Fax | 281-890-6865
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Provider Business Mailing Address
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Address Line | 20202 TAMERTON DR
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City | SPRING
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State | TX
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Zip | 77388-3182
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Country | US
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Telephone | 281-890-6800
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Fax | 281-890-6865
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | USHA PATEL
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Credential |
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Telephone | 281-890-6800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | K3399
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License Number State | TX
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