NPIMap

Organization Active NPI

Stafford Medical Clinic Occcupation and Urgent Care

  • Clinic/Center
  • Stafford, TX
National Provider Identifier
1487057873
Registry record updated Sep 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
L4811 Issued in TX
Legal business name
STAFFORD MEDICAL CLINIC OCCCUPATION AND URGENT CARE
Practice address
3832 Greenbriar Dr
Stafford, TX 77477-3926
Phone
(281) 980-1901
Fax
(281) 980-1851
NPI assigned
Sep 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Wojciech Stanislaw Witkowski, MD
Title
Owner
Phone
(281) 980-1901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X L4811 TX Primary

Addresses

Primary practice location

3832 Greenbriar Dr
Stafford, TX 77477-3926

Mailing address

3832 Greenbriar Dr
Stafford, TX 77477-3926
Phone (281) 980-1901

Other identifiers 1

IdentifierTypeStateIssuer
164524701MedicaidTX

National Provider Directory

National Provider Directory

Locations

3832 Greenbriar Dr
Stafford, TX 77477
Phone (281) 980-1901

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1487057873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3832 GREENBRIAR DR",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773926",
            "telephone_number": "281-980-1901",
            "fax_number": "281-980-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3832 GREENBRIAR DR",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774773926",
            "telephone_number": "281-980-1901",
            "fax_number": "281-980-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAFFORD MEDICAL CLINIC OCCCUPATION AND URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "WITKOWSKI",
        "authorized_official_first_name": "WOJCIECH",
        "authorized_official_middle_name": "STANISLAW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-980-1901",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "L4811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164524701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stafford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.