Healthcare Provider Details

I. General information

NPI: 1275664054
Provider Name (Legal Business Name): MJHEATH ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8323 CAMP BOWIE W
FORT WORTH TX
76116-6319
US

IV. Provider business mailing address

8323 CAMP BOWIE W
FORT WORTH TX
76116-6319
US

V. Phone/Fax

Practice location:
  • Phone: 817-244-1105
  • Fax: 817-244-9231
Mailing address:
  • Phone: 817-244-1105
  • Fax: 817-244-9231

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: MR. JOHN HEATH
Title or Position: OWNER
Credential:
Phone: 817-244-1105