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General NPI Number Information
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NPI Number | 1871245738
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Entity Type | Organization
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Legal Business Name | MKB SOLUTIONS LLC
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 02/04/2022
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Provider Practice Location Address
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Address Line | 5012 URBAN CREST RD
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City | DALLAS
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State | TX
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Zip | 75227-2833
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Country | US
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Telephone | 800-536-0774
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Fax | 817-549-7775
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Provider Business Mailing Address
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Address Line | 2708 HAWTHORNE DR
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City | GLENN HEIGHTS
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State | TX
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Zip | 75154-2152
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Country | US
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Telephone | 800-536-0774
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Fax | 817-549-7775
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Authorized Official
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Title or Position | DIRECTOR
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Name | KESEYA KEMYADA BOYD
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Credential | RN BSN
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Telephone | 800-536-0774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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