MEDICARE: PHYSICIANS URGENT CARE PLLC

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		TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0018ZD	OTHER	TX	BCBSTX

General Provider Information

NPI Number	:	1316371263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS URGENT CARE PLLC

Provider Business Mailing Address
First Line	:	PO BOX 38041
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77238-8041
Country	:	US
Telephone Number	:	832-978-6098
Fax Number	:	281-890-3844

Provider Business Practice Location Address
First Line	:	10311 N ELDRIDGE PKWY
Second Line	:	STE B5
City	:	HOUSTON
State	:	TX
Zip	:	77065-5368
Country	:	US
Telephone Number	:	281-890-3822
Fax Number	:	281-890-3844

Authorized Official
Title or Position	:	OWNER
Name	:	SYED NASER MUJEEB
Credential	:	M.D.
Telephone Number	:	281-890-3822

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	05/20/2021

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