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NPI Code Detail

MEDICARE: SEALY FAST TRACK LLC

MEDICARE: SEALY FAST TRACK 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
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1891196820
Entity Type Code : Organization
Provider Name (Legal Business Name) : SEALY FAST TRACK LLC
Provider Business Mailing Address
First Line : 1036 N CIRCLE DR STE 102
Second Line :
City : SEALY
State : TX
Zip : 77474-3336
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1036 N CIRCLE DR STE 102
Second Line :
City : SEALY
State : TX
Zip : 77474-3336
Country : US
Telephone Number : 979-877-0022
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : KANNAPPAN KRISHNASWAMY
Credential : MD
Telephone Number : 979-877-0022
Provider Enumeration Date : 09/09/2014
Last Update Date : 10/24/2014

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Directions to “SEALY FAST TRACK LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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