Healthcare Provider Details

I. General information

NPI: 1639568140
Provider Name (Legal Business Name): MSL MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 01/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4124 GUS THOMASSON RD
MESQUITE TX
75150-2226
US

IV. Provider business mailing address

4124 GUS THOMASSON RD
MESQUITE TX
75150-2226
US

V. Phone/Fax

Practice location:
  • Phone: 972-523-7370
  • Fax:
Mailing address:
  • Phone: 972-523-7370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: PARAMPOTTIL ISSAC
Title or Position: MEMBER
Credential:
Phone: 972-523-7370