1235701327 NPI number — MORE MD PLLC

Table of content: (NPI 1235701327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235701327 NPI number — MORE MD PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MORE MD PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SERVE MD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235701327
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7431 COLTON LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PILOT POINT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76258-7352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8700 E UNIVERSITY DR
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
CROSSROADS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76227
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
940-290-0200
Provider Business Practice Location Address Fax Number:
940-488-7533
Provider Enumeration Date:
07/16/2021

Additional Information

Authorized Official

Authorized Official Last Name:
MOHINDRA
Authorized Official First Name:
RAGHAV
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
623-363-0644

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2E9284 . This is a "NOVITAS SOLUTIONS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com