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General NPI Number Information
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NPI Number | 1457919714
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Entity Type | Organization
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Legal Business Name | MBG MANAGEMENT GROUP LLC
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 09/18/2023
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Provider Practice Location Address
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Address Line | 8034 CULEBRA RD STE 509
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City | SAN ANTONIO
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State | TX
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Zip | 78251-1895
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Country | US
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Telephone | 210-281-8727
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Fax | 888-369-9198
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Provider Business Mailing Address
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Address Line | 8034 CULEBRA RD STE 509
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City | SAN ANTONIO
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State | TX
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Zip | 78251-1895
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Country | US
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Telephone | 210-281-8727
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Fax | 888-369-9198
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Authorized Official
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Title or Position | OWNER
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Name | MRS. BRANDY T GOMEZ
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Credential | ADMINISTRATOR
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Telephone | 210-281-8727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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