Healthcare Provider Details
I. General information
NPI: 1326219593
Provider Name (Legal Business Name): WORTHINGTON MEDICAL BILLING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/17/2008
Last Update Date: 03/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
33300 EGYPT LN STE F200
MAGNOLIA TX
77354-2741
US
IV. Provider business mailing address
33300 EGYPT LN STE F200
MAGNOLIA TX
77354-2741
US
V. Phone/Fax
- Phone: 281-292-1121
- Fax:
- Phone: 281-292-1121
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204C00000X |
| Taxonomy | Sports Medicine (Neuromusculoskeletal Medicine) Physician |
| License Number | M0921 |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
SAQIB
SIDDIQUI
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 281-292-1121