MEDICARE: NASA URGENT CARE INC.

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	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1821542432
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NASA URGENT CARE INC.

Provider Business Mailing Address
First Line	:	985 NASA PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3039
Country	:	US
Telephone Number	:	281-218-6777
Fax Number	:	800-708-5070

Provider Business Practice Location Address
First Line	:	985 NASA PKWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77058-3039
Country	:	US
Telephone Number	:	713-893-6214
Fax Number	:	800-708-5070

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	BRAD PETERSON
Credential	:
Telephone Number	:	713-893-6214

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	02/10/2021

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