Provider Demographics
NPI:1710053459
Name:MGM -VISION HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:MGM -VISION HEALTHCARE SERVICES INC
Other - Org Name:TOFY HEALTHCARE SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSUWAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:832-777-7744
Mailing Address - Street 1:4606 FM 1960 RD W STE 215
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4617
Mailing Address - Country:US
Mailing Address - Phone:832-777-7744
Mailing Address - Fax:832-900-0011
Practice Address - Street 1:4606 FM 1960 RD W STE 215
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4617
Practice Address - Country:US
Practice Address - Phone:832-777-7744
Practice Address - Fax:832-900-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008420251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679349Medicare ID - Type Unspecified