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General NPI Number Information
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NPI Number | 1467206599
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Entity Type | Organization
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Legal Business Name | EXCELLENCE SPECIALITY CLINIC PLLC
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 15119 WALLISVILLE RD STE 100
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City | HOUSTON
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State | TX
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Zip | 77049-4629
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Country | US
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Telephone | 281-428-8203
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Fax | 281-428-0624
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Provider Business Mailing Address
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Address Line | 15119 WALLISVILLE RD STE 100
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City | HOUSTON
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State | TX
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Zip | 77049-4629
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Country | US
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Telephone | 281-428-8203
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Fax | 281-428-0624
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. HAIDER AFZAL
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Credential | MD
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Telephone | 281-428-8203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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