=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962221226
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WALK IN CARE CLINICS OF TEXAS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2024
-----------------------------------------------------
Last Update Date | 12/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2030 N STATE HWY 78 SUITE 500
-----------------------------------------------------
City | SACHSE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75048
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-992-9572
-----------------------------------------------------
Fax | 469-969-0103
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8009 GRAYSTONE DR
-----------------------------------------------------
City | SACHSE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75048-3825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. RIDHAM PATEL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 214-476-0292
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------