Organization
MT HOUSTON URGENT CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA ANN SHIRAH ADMINISTRATOR (CREDENTIALING SUPERVISOR)
(281) 646-1935
Entity
Organization
Contact information
Practice address
11753 W BELLFORT ST, STE 100, STAFFORD, TX 77477-1327
(281) 495-1178
(281) 646-0927
Mailing address
11753 W BELLFORT ST, STE 100, STAFFORD, TX 77477-1327
(281) 495-1178
(281) 646-0927
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
G9083
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052LX
BCBS GROUP ID
TX
Enumeration date
04/10/2007
Last updated
11/13/2007
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