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General NPI Number Information
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NPI Number | 1225921364
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Entity Type | Organization
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Legal Business Name | MM MOBILE WOUND CARE PLLC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 5330 N LOOP 1604 W STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4384
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Country | US
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Telephone | 512-476-2830
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Fax |
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Provider Business Mailing Address
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Address Line | 5330 N LOOP 1604 W STE 101
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City | SAN ANTONIO
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State | TX
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Zip | 78249-4384
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Country | US
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Telephone | 512-476-2830
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL MOGHIMI
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Credential | MD
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Telephone | 512-476-2830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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