Healthcare Provider Details

I. General information

NPI: 1871245738
Provider Name (Legal Business Name): MKB SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2022
Last Update Date: 02/04/2022
Certification Date: 02/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5012 URBAN CREST RD
DALLAS TX
75227-2833
US

IV. Provider business mailing address

2708 HAWTHORNE DR
GLENN HEIGHTS TX
75154-2152
US

V. Phone/Fax

Practice location:
  • Phone: 800-536-0774
  • Fax: 817-549-7775
Mailing address:
  • Phone: 800-536-0774
  • Fax: 817-549-7775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: KESEYA KEMYADA BOYD
Title or Position: DIRECTOR
Credential: RN BSN
Phone: 800-536-0774