MEDICARE: BRAESWOOD URGENT CARE AND FAMILY CLINIC

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	363LF0000X	Family Nurse Practitioner	760924	TX
2	261QU0200X	Urgent Care Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740797539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAESWOOD URGENT CARE AND FAMILY CLINIC

Provider Business Mailing Address
First Line	:	8622 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-1301
Country	:	US
Telephone Number	:	281-888-5598
Fax Number	:

Provider Business Practice Location Address
First Line	:	8622 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77031-1301
Country	:	US
Telephone Number	:	281-888-5598
Fax Number	:	281-888-5598

Authorized Official
Title or Position	:	MANAGER
Name	:	IRENE TOPPAR
Credential	:	NP-C
Telephone Number	:	281-888-5598

Provider Enumeration Date	:	01/03/2018
Last Update Date	:	01/03/2018

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Directions to “BRAESWOOD URGENT CARE AND FAMILY CLINIC ” Practice Location

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