Healthcare Provider Details

I. General information

NPI: 1033327200
Provider Name (Legal Business Name): MUGEER OMAR B.C.,H.I.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 DALLAS DR SUITE #C2
DENTON TX
76205-5291
US

IV. Provider business mailing address

301 DALLAS DR SUITE #C2
DENTON TX
76205-5291
US

V. Phone/Fax

Practice location:
  • Phone: 940-243-2766
  • Fax: 940-320-3570
Mailing address:
  • Phone: 940-243-2766
  • Fax: 940-320-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number50665
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: