MEDICARE: MISSOURI RAPIDCARE ER LLC

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	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1750013769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSOURI RAPIDCARE ER LLC

Provider Business Mailing Address
First Line	:	2014 WENTWORTH ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-6084
Country	:	US
Telephone Number	:	832-210-0744
Fax Number	:

Provider Business Practice Location Address
First Line	:	4885 HIGHWAY 6
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-3987
Country	:	US
Telephone Number	:	832-210-0744
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	HUMAIRA QURESHI
Credential	:
Telephone Number	:	281-712-8033

Provider Enumeration Date	:	06/28/2022
Last Update Date	:	01/04/2024

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