MEDICARE: MKB SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1871245738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MKB SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	2708 HAWTHORNE DR
Second Line	:
City	:	GLENN HEIGHTS
State	:	TX
Zip	:	75154-2152
Country	:	US
Telephone Number	:	800-536-0774
Fax Number	:	817-549-7775

Provider Business Practice Location Address
First Line	:	5012 URBAN CREST RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75227-2833
Country	:	US
Telephone Number	:	800-536-0774
Fax Number	:	817-549-7775

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KESEYA KEMYADA BOYD
Credential	:	RN BSN
Telephone Number	:	800-536-0774

Provider Enumeration Date	:	01/21/2022
Last Update Date	:	02/04/2022

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