Healthcare Provider Details
I. General information
NPI: 1619661105
Provider Name (Legal Business Name): MAS VASCULAR PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/07/2023
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
109 E TORONTO AVE STE 100
MCALLEN TX
78503-1224
US
IV. Provider business mailing address
4771 SWEETWATER BLVD # 337
SUGAR LAND TX
77479-3121
US
V. Phone/Fax
- Phone: 956-803-0104
- Fax:
- Phone: 953-803-0104
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOHAMMAD
ALI
SAEED
Title or Position: OWNER
Credential: MD
Phone: 956-803-0104