Healthcare Provider Details

I. General information

NPI: 1386564284
Provider Name (Legal Business Name): MEDIXA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 CONSER AVE APT 3
POTEAU OK
74953-4814
US

IV. Provider business mailing address

102 CONSER AVE APT 3
POTEAU OK
74953-4814
US

V. Phone/Fax

Practice location:
  • Phone: 214-586-0590
  • Fax: 213-449-3733
Mailing address:
  • Phone: 513-410-5739
  • Fax: 213-449-3733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: HAMZA GHUMMAN
Title or Position: OWNER
Credential:
Phone: 513-410-5739