Provider Demographics
NPI:1215330501
Name:COLUMBUS URGENT CARE PA
Entity type:Organization
Organization Name:COLUMBUS URGENT CARE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAUF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-893-6214
Mailing Address - Street 1:926 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934-2215
Mailing Address - Country:US
Mailing Address - Phone:713-893-6214
Mailing Address - Fax:718-640-2713
Practice Address - Street 1:926 WALNUT ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-2215
Practice Address - Country:US
Practice Address - Phone:713-893-4773
Practice Address - Fax:800-708-5070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
208D00000X, 261Q00000X, 208D00000X
TX261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347139301Medicaid
TX399951Medicare PIN