Provider Demographics
NPI:1164004362
Name:ELITE URGENT CARE PLLC
Entity type:Organization
Organization Name:ELITE URGENT CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:CHAITHANYA
Authorized Official - Last Name:TATINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-269-0272
Mailing Address - Street 1:14660 STATE HIGHWAY 121 STE 200
Mailing Address - Street 2:BLDG B
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-4634
Mailing Address - Country:US
Mailing Address - Phone:469-269-0272
Mailing Address - Fax:469-854-2143
Practice Address - Street 1:14660 STATE HIGHWAY 121 STE 200
Practice Address - Street 2:BLDG B
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-4634
Practice Address - Country:US
Practice Address - Phone:469-269-0272
Practice Address - Fax:469-854-2143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care