Provider Demographics
NPI:1467462523
Name:2M HEALTHWATCH PROFESSIONALS, INC.
Entity Type:Organization
Organization Name:2M HEALTHWATCH PROFESSIONALS, INC.
Other - Org Name:HEALTHWATCH PROFESSIONALS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MULUGETA
Authorized Official - Middle Name:
Authorized Official - Last Name:GHEBREMARIAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-792-7770
Mailing Address - Street 1:1100 E CAMPBELL RD # 215
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6708
Mailing Address - Country:US
Mailing Address - Phone:972-792-7770
Mailing Address - Fax:972-792-7448
Practice Address - Street 1:1100 E CAMPBELL RD # 215
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6708
Practice Address - Country:US
Practice Address - Phone:972-792-7770
Practice Address - Fax:972-792-7448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009773251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1=========0000Medicaid
679271Medicare ID - Type UnspecifiedHOME HEALTH AGENCY