| Modern Med Integrative Health | |
|
281 W Southlake Blvd Southlake TX 76092-7052 | |
| (469) 200-4093 | |
| (469) 200-4079 |
| Full Name | Modern Med Integrative Health |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 281 W Southlake Blvd, Southlake, Texas |
| Authorized Official Name and Position | Nazimuddin Mohammed (OWNER) |
| Authorized Official Contact | 4692004093 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Med Integrative Health 281 W Southlake Blvd Southlake TX 76092-7052 Ph: (469) 200-4093 | Modern Med Integrative Health 281 W Southlake Blvd Southlake TX 76092-7052 Ph: (469) 200-4093 |
| NPI Number | 1689494056 |
|---|---|
| Provider Enumeration Date | 10/11/2024 |
| Last Update Date | 10/11/2024 |
| Certification Date | 10/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689494056 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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