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NPI Code Detail

MEDICARE: TRI-CITY FAMILY MEDICINE & URGENT CARE CLINIC, PLLC

MEDICARE: TRI-CITY FAMILY MEDICINE & URGENT CARE CLINIC, 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
1261QU0200XUrgent Care Clinic/Center
2261QP2300XPrimary Care Clinic/Center
3261QM1300XMulti-Specialty Clinic/Center
4261Q00000XClinic/Center
5207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1457531790
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI-CITY FAMILY MEDICINE & URGENT CARE CLINIC, PLLC
Provider Business Mailing Address
First Line : 107 HYANNIS DR
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-8336
Country : US
Telephone Number : 919-363-8666
Fax Number : 919-363-8668
Provider Business Practice Location Address
First Line : 107 HYANNIS DR
Second Line :
City : HOLLY SPRINGS
State : NC
Zip : 27540-8336
Country : US
Telephone Number : 919-363-8666
Fax Number : 919-363-8668
Authorized Official
Title or Position : PRACTICE ADMINISTRATOR
Name : AVANI PATEL
Credential :
Telephone Number : 919-363-8666
Provider Enumeration Date : 11/04/2007
Last Update Date : 01/01/2026

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