Provider Demographics
NPI:1841982436
Name:MOBILE MED VISIT MANAGEMENT LLC
Entity type:Organization
Organization Name:MOBILE MED VISIT MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ABDUL WAHAB
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:KAZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-999-5949
Mailing Address - Street 1:275 W CAMPBELL RD STE 325C
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3601
Mailing Address - Country:US
Mailing Address - Phone:972-666-0786
Mailing Address - Fax:972-666-0535
Practice Address - Street 1:275 W CAMPBELL RD STE 325C
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3601
Practice Address - Country:US
Practice Address - Phone:972-666-0786
Practice Address - Fax:972-666-0535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty