Healthcare Provider Details

I. General information

NPI: 1073043477
Provider Name (Legal Business Name): NIRAK INVESTMENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MOSS HILL DR
ARLINGTON TX
76018-4025
US

IV. Provider business mailing address

121 MOSS HILL DR
ARLINGTON TX
76018-4025
US

V. Phone/Fax

Practice location:
  • Phone: 254-625-1692
  • Fax: 469-453-3111
Mailing address:
  • Phone: 254-625-1692
  • Fax: 469-453-3111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: ABIODUN VICTOR OBINIRAN
Title or Position: OWNER
Credential:
Phone: 254-625-1692