Provider Demographics
NPI:1467454710
Name:EZ MOBILITY, INC.
Entity Type:Organization
Organization Name:EZ MOBILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-551-3110
Mailing Address - Street 1:9929 W UNIVERSITY DR
Mailing Address - Street 2:STE 305
Mailing Address - City:MC KINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7439
Mailing Address - Country:US
Mailing Address - Phone:972-562-1441
Mailing Address - Fax:972-562-1331
Practice Address - Street 1:9929 W UNIVERSITY DR
Practice Address - Street 2:STE 305
Practice Address - City:MC KINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7439
Practice Address - Country:US
Practice Address - Phone:972-562-1441
Practice Address - Fax:972-562-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4582322Medicaid
LA1179884Medicaid
LA1179884Medicaid