Provider Demographics
NPI:1821533787
Name:MMV ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:MMV ASSOCIATES, PLLC
Other - Org Name:VECTOR HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-544-3339
Mailing Address - Street 1:9 MEDICAL PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7852
Mailing Address - Country:US
Mailing Address - Phone:888-544-3339
Mailing Address - Fax:214-853-5728
Practice Address - Street 1:9 MEDICAL PKWY STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7852
Practice Address - Country:US
Practice Address - Phone:888-544-3339
Practice Address - Fax:214-853-5728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-03
Last Update Date:2023-05-25
Deactivation Date:2019-04-18
Deactivation Code:
Reactivation Date:2022-08-22
Provider Licenses
StateLicense IDTaxonomies
2084N0600X, 332B00000X
TXN6605246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Multi-Specialty
No246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty