Provider Demographics
NPI:1275062572
Name:VMA PARTNERS LLC
Entity Type:Organization
Organization Name:VMA PARTNERS LLC
Other - Org Name:VMA PARTNERS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MAYABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-203-8453
Mailing Address - Street 1:PO BOX 470667
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76147-0667
Mailing Address - Country:US
Mailing Address - Phone:713-203-8453
Mailing Address - Fax:877-443-0992
Practice Address - Street 1:1307 8TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4137
Practice Address - Country:US
Practice Address - Phone:713-203-8453
Practice Address - Fax:877-443-0992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology