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General NPI Number Information
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NPI Number | 1033724828
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Entity Type | Organization
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Legal Business Name | XIMMY LLC
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Dates
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Enumeration Date | 09/09/2020
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Last Update Date | 09/09/2020
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Provider Practice Location Address
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Address Line | 8715 VILLAGE DR STE 612
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City | SAN ANTONIO
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State | TX
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Zip | 78217-5407
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Country | US
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Telephone | 240-487-1317
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Fax |
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Provider Business Mailing Address
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Address Line | 3831 HARRY WURZBACH RD BLDG 20
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City | SAN ANTONIO
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State | TX
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Zip | 78209-3175
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. MUDASSAR AHMAD
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Credential | MD
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Telephone | 240-487-1317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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