Provider Demographics
NPI:1821605312
Name:MMK GROUP OF TEXAS
Entity Type:Organization
Organization Name:MMK GROUP OF TEXAS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MACK
Authorized Official - Middle Name:ELLIS
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:701-441-1551
Mailing Address - Street 1:21510 HALES HUNT CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-6952
Mailing Address - Country:US
Mailing Address - Phone:701-441-1552
Mailing Address - Fax:
Practice Address - Street 1:21510 HALES HUNT CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-6952
Practice Address - Country:US
Practice Address - Phone:701-441-1552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management