Provider Demographics
NPI:1891162947
Name:Q. M. H. V. INC.
Entity Type:Organization
Organization Name:Q. M. H. V. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LUKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:903-356-3777
Mailing Address - Street 1:9611 PRIVATE ROAD 3826
Mailing Address - Street 2:
Mailing Address - City:QUINLAN
Mailing Address - State:TX
Mailing Address - Zip Code:75474-3931
Mailing Address - Country:US
Mailing Address - Phone:903-356-3777
Mailing Address - Fax:
Practice Address - Street 1:9611 PRIVATE ROAD 3826
Practice Address - Street 2:
Practice Address - City:QUINLAN
Practice Address - State:TX
Practice Address - Zip Code:75474-3931
Practice Address - Country:US
Practice Address - Phone:903-356-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA01124363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty