Provider Demographics
NPI:1134503873
Name:AMI MEDICAL MONITORING, LLC
Entity Type:Organization
Organization Name:AMI MEDICAL MONITORING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:PALACIOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-368-4666
Mailing Address - Street 1:4849 GREENVILLE AVE
Mailing Address - Street 2:STE 1125
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-4155
Mailing Address - Country:US
Mailing Address - Phone:214-368-4666
Mailing Address - Fax:214-368-4668
Practice Address - Street 1:4849 GREENVILLE AVE
Practice Address - Street 2:STE 1125
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-4155
Practice Address - Country:US
Practice Address - Phone:214-368-4666
Practice Address - Fax:214-368-4668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty