=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740126739
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDVANTA MEDICAL BILLING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2026
-----------------------------------------------------
Last Update Date | 04/24/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12100 S HIGHWAY 6
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77498-5712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-289-2158
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12100 S HIGHWAY 6
-----------------------------------------------------
City | SUGAR LAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77498-5712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 307-289-2158
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MAHMOOD ASHIQ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 307-289-2158
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BC3200X
-----------------------------------------------------
Taxonomy Name | Customized Equipment (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------