Provider Demographics
NPI:1740143890
Name:PROSPER PRIMARY CARE AND WELLNESS PC
Entity type:Organization
Organization Name:PROSPER PRIMARY CARE AND WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUHAIB
Authorized Official - Middle Name:
Authorized Official - Last Name:TAIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-592-6599
Mailing Address - Street 1:3740 W UNIVERSITY DR STE 50
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-9993
Mailing Address - Country:US
Mailing Address - Phone:469-592-6599
Mailing Address - Fax:
Practice Address - Street 1:3740 W UNIVERSITY DR STE 50
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9993
Practice Address - Country:US
Practice Address - Phone:469-592-6599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-05
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care