Provider Demographics
NPI:1699483800
Name:COMMUNITY URGENT CARE, LLC
Entity type:Organization
Organization Name:COMMUNITY URGENT CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-826-9974
Mailing Address - Street 1:PO BOX 941805
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75094-1805
Mailing Address - Country:US
Mailing Address - Phone:469-482-0861
Mailing Address - Fax:469-273-1720
Practice Address - Street 1:749 N WALDRIP ST
Practice Address - Street 2:
Practice Address - City:GRAND SALINE
Practice Address - State:TX
Practice Address - Zip Code:75140-1555
Practice Address - Country:US
Practice Address - Phone:281-826-9974
Practice Address - Fax:832-698-4047
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY URGENT CARE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-08
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty