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General NPI Number Information
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NPI Number | 1932859212
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Entity Type | Organization
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Legal Business Name | EXCELLENCE CARE CLINIC MD PA
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 19701 KINGWOOD DR BUILDING 9
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City | KINGWOOD
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State | TX
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Zip | 77339-3775
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Country | US
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Telephone | 304-435-7573
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Fax | 832-516-6184
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Provider Business Mailing Address
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Address Line | PO BOX 540088
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City | HOUSTON
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State | TX
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Zip | 77254-0088
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Country | US
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Telephone | 713-850-1190
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RIZWAN ALI
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Credential | MD
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Telephone | 832-516-6184
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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 |
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License Number State |
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