Provider Demographics
NPI:1497443816
Name:MPS HOME THERAPIES, PLLC
Entity Type:Organization
Organization Name:MPS HOME THERAPIES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MAYBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMFUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-771-1386
Mailing Address - Street 1:PO BOX 54136
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79453-4136
Mailing Address - Country:US
Mailing Address - Phone:806-771-1386
Mailing Address - Fax:806-771-1388
Practice Address - Street 1:3626 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-3994
Practice Address - Country:US
Practice Address - Phone:806-771-1386
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
No251E00000XAgenciesHome Health