Provider Demographics
NPI:1609599554
Name:NG100M, P.C.
Entity Type:Organization
Organization Name:NG100M, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTER OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MOMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAFARULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:210-862-4199
Mailing Address - Street 1:2730 VIRGINIA PKWY # 200A
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5088
Mailing Address - Country:US
Mailing Address - Phone:800-975-3859
Mailing Address - Fax:800-975-3859
Practice Address - Street 1:2730 VIRGINIA PKWY # 200A
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5088
Practice Address - Country:US
Practice Address - Phone:800-975-3859
Practice Address - Fax:800-975-3859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-26
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty