MEDICARE: HOSPITAL MEDICAL MANAGEMENT SERVICES, 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	207P00000X	Emergency Medicine Physician
2	208M00000X	Hospitalist Physician	N6185	TX
3	208M00000X	Hospitalist Physician

General Provider Information

NPI Number	:	1518343706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOSPITAL MEDICAL MANAGEMENT SERVICES, LLC

Provider Business Mailing Address
First Line	:	6363 PINTAIL LN
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75034-2290
Country	:	US
Telephone Number	:	310-597-0032
Fax Number	:	469-301-2420

Provider Business Practice Location Address
First Line	:	8111 MEADOW RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3514
Country	:	US
Telephone Number	:	310-597-0032
Fax Number	:	469-301-2420

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	RAMI H BOUAJRAM
Credential	:	MD
Telephone Number	:	310-597-0032

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	09/06/2023

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