| Mobile Med Visit Management Llc | |
|
275 W Campbell Rd Ste 325c Richardson TX 75080-3601 | |
| (972) 666-0786 | |
| (972) 666-0535 |
| Full Name | Mobile Med Visit Management Llc |
|---|---|
| Speciality | General Practice |
| Location | 275 W Campbell Rd Ste 325c, Richardson, Texas |
| Authorized Official Name and Position | Abdul Wahab Ahmed Kazi (MANAGING MEMBER) |
| Authorized Official Contact | 4699995949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Med Visit Management Llc 275 W Campbell Rd Ste 325c Richardson TX 75080-3601 Ph: (972) 666-0786 | Mobile Med Visit Management Llc 275 W Campbell Rd Ste 325c Richardson TX 75080-3601 Ph: (972) 666-0786 |
| NPI Number | 1841982436 |
|---|---|
| Provider Enumeration Date | 05/23/2023 |
| Last Update Date | 11/13/2023 |
| Medicare PECOS PAC ID | 1557723137 |
|---|---|
| Medicare Enrollment ID | O20230814002594 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841982436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Mansoor Kazi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689004996 PECOS PAC ID: 0345498820 Enrollment ID: I20140728002295 |
| Provider Name | Corretta D Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568071504 PECOS PAC ID: 5799197141 Enrollment ID: I20201209001949 |
| Provider Name | Pedro Daniel Paez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1235765181 PECOS PAC ID: 7315324753 Enrollment ID: I20220524002212 |
| Provider Name | Hazel Violan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184355034 PECOS PAC ID: 9638547284 Enrollment ID: I20221201002527 |
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