Organization Name: | SREE-DOC URGENT CARE MANAGEMENT LLC |
NPI Number: | 1275914640 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MADHU S POTLA (ADMINISTRATOR) |
Mailing Address: | 8787 N Macarthur Blvd Suite No 120 B Irving |
State: | TX US |
Postal Code: | 750635446 |
Phone Number: | 8648845166 |
Fax Number: | |
NPI Enumeration Date: | 06/11/2015 |
NPI Last Update Date: | 06/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | P7542 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |