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General NPI Number Information
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NPI Number | 1942928064
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Entity Type | Organization
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Legal Business Name | SRM URGENT CARE PLLC
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 3514 HIGHWAY 36 S STE 600
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City | ROSENBERG
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State | TX
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Zip | 77471-9119
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Country | US
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Telephone | 716-601-4010
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Fax |
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Provider Business Mailing Address
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Address Line | 3514 HIGHWAY 36 S STE 600
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City | ROSENBERG
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State | TX
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Zip | 77471-9119
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR/MANAGER
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Name | JIGISHA TANMAY SHAH
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Credential | MD
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Telephone | 716-601-4010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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