Provider Demographics
NPI:1477835254
Name:ALEX MOMPOINT MD PLLC
Entity Type:Organization
Organization Name:ALEX MOMPOINT MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MOMPOINT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-658-3459
Mailing Address - Street 1:3839 MCKINNEY AVE STE 155-256
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-1413
Mailing Address - Country:US
Mailing Address - Phone:402-658-3459
Mailing Address - Fax:
Practice Address - Street 1:3839 MCKINNEY AVE STE 155-256
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-1413
Practice Address - Country:US
Practice Address - Phone:402-658-3459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB144217Medicare PIN