MEDICARE: ELITE 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

General Provider Information

NPI Number	:	1811820038
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE URGENT CARE PLLC

Provider Business Mailing Address
First Line	:	85 INTERSTATE 10 N STE 110
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-2560
Country	:	US
Telephone Number	:	409-853-1885
Fax Number	:	866-397-8681

Provider Business Practice Location Address
First Line	:	5760 WALDEN RD STE 242
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77707-5515
Country	:	US
Telephone Number	:	409-853-1885
Fax Number	:	866-397-8681

Authorized Official
Title or Position	:	OWNER
Name	:	SHOLANDA JACOBS
Credential	:
Telephone Number	:	337-315-7927

Provider Enumeration Date	:	06/06/2026
Last Update Date	:	06/06/2026

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Directions to “ELITE URGENT CARE PLLC ” Practice Location

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