MEDICARE: FAST AND URGENT CARE MDPA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1154701449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAST AND URGENT CARE MDPA

Provider Business Mailing Address
First Line	:	7701 W BELLFORT ST
Second Line	:	SUITE B
City	:	HOUSTON
State	:	TX
Zip	:	77071-2104
Country	:	US
Telephone Number	:	713-592-9500
Fax Number	:	888-776-9171

Provider Business Practice Location Address
First Line	:	7701 W BELLFORT ST
Second Line	:	SUITE B
City	:	HOUSTON
State	:	TX
Zip	:	77071-2104
Country	:	US
Telephone Number	:	713-592-9500
Fax Number	:	888-776-9171

Authorized Official
Title or Position	:	CEO
Name	:	NOAH DAVIS
Credential	:
Telephone Number	:	713-592-9500

Provider Enumeration Date	:	06/02/2015
Last Update Date	:	06/02/2015

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