Provider Demographics
NPI:1578304036
Name:PURE NUR MEDSPA PLLC
Entity type:Organization
Organization Name:PURE NUR MEDSPA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:UMAR
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAHMOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:361-360-3264
Mailing Address - Street 1:2700 CITIZENS PLZ STE 207
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5755
Mailing Address - Country:US
Mailing Address - Phone:361-360-3264
Mailing Address - Fax:361-232-4600
Practice Address - Street 1:2700 CITIZENS PLZ STE 207
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5755
Practice Address - Country:US
Practice Address - Phone:361-360-3264
Practice Address - Fax:361-232-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty