MEDICARE: PROHEALTH MOBILITY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BD1200X	Dialysis Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1194695148
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROHEALTH MOBILITY LLC

Provider Business Mailing Address
First Line	:	1301 JUSTIN RD STE 201
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75077-2183
Country	:	US
Telephone Number	:	510-953-5799
Fax Number	:	214-292-9630

Provider Business Practice Location Address
First Line	:	1301 JUSTIN RD
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75077-2183
Country	:	US
Telephone Number	:	510-953-5799
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HAMZA KHAN
Credential	:
Telephone Number	:	510-953-5799

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	02/04/2026

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Directions to “PROHEALTH MOBILITY LLC ” Practice Location

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