| Blue Light Therapies Llc | |
|
421 E Royal Ln Suite 100 Irving TX 75039 | |
| (469) 226-7516 | |
| Not Available |
| Full Name | Blue Light Therapies Llc |
|---|---|
| Speciality | Clinic/center - Health Service |
| Location | 421 E Royal Ln Suite 100, Irving, Texas |
| Authorized Official Name and Position | Hannah Nur Mohamed (CEO) |
| Authorized Official Contact | 4692267516 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Light Therapies Llc 421 E Royal Ln Suite 100 Irving TX 75039 Ph: (469) 226-7516 | Blue Light Therapies Llc 421 E Royal Ln Suite 100 Irving TX 75039 Ph: (469) 226-7516 |
| NPI Number | 1457976714 |
|---|---|
| Provider Enumeration Date | 06/12/2020 |
| Last Update Date | 08/31/2022 |
| Certification Date | 08/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457976714 | NPI | - | NPPES |
| 1386106623 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Primary |
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