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General NPI Number Information
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NPI Number | 1063219152
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Entity Type | Organization
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Legal Business Name | BEHIND THE SCENE WITH MZDEE LLC
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 100 ELMORE LOOP
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City | SHEPHERD
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State | TX
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Zip | 77371-6638
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Country | US
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Telephone | 936-223-9262
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Fax |
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Provider Business Mailing Address
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Address Line | 100 ELMORE LOOP
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City | SHEPHERD
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State | TX
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Zip | 77371-6638
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Country | US
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Telephone | 936-223-9262
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DENDRA JANELLE BUTLER
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Credential |
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Telephone | 936-223-5213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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