MEDICARE: MMKM, INC

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	251E00000X	Home Health Agency	014832	TX

General Provider Information

NPI Number	:	1356527808
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MMKM, INC

Provider Business Mailing Address
First Line	:	7400 LIVINGSTON DR
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-3496
Country	:	US
Telephone Number	:	940-382-7548
Fax Number	:	940-382-7645

Provider Business Practice Location Address
First Line	:	7400 LIVINGSTON DR
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-3496
Country	:	US
Telephone Number	:	940-382-7548
Fax Number	:	940-382-7645

Authorized Official
Title or Position	:	ADMINISTRATOR/OWNER
Name	:	MS. KIMBERLY MARIE TRUAX
Credential	:	C.A.L.M
Telephone Number	:	940-382-7548

Provider Enumeration Date	:	01/15/2008
Last Update Date	:	12/02/2024

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