=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386033413
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HORIZON URGENT CARE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/13/2015
-----------------------------------------------------
Last Update Date | 01/13/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19255 PARK ROW SUITE 105
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77084-7309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-742-6012
-----------------------------------------------------
Fax | 281-668-6392
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19255 PARK ROW SUITE 105
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77084-7309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-742-6012
-----------------------------------------------------
Fax | 281-668-6392
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. SYED FARHAT ZAIDI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 832-742-6012
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------