Provider Demographics
NPI:1578861829
Name:MBE DYNAMIC HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:MBE DYNAMIC HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOE
Authorized Official - Middle Name:
Authorized Official - Last Name:EZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-488-8000
Mailing Address - Street 1:2727 LBJ FWY
Mailing Address - Street 2:STE 300
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7334
Mailing Address - Country:US
Mailing Address - Phone:972-488-8000
Mailing Address - Fax:972-488-8009
Practice Address - Street 1:2727 LBJ FWY
Practice Address - Street 2:STE 300
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7334
Practice Address - Country:US
Practice Address - Phone:972-488-8000
Practice Address - Fax:972-488-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health