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NPI Code Detail

MEDICARE: DMB MEDICAL MANAGEMENT LLC

MEDICARE: DMB MEDICAL MANAGEMENT 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
1363LF0000XFamily Nurse Practitioner

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AP130342OTHERTXTEXAS MEDICAL LICENSE

General Provider Information

NPI Number : 1689185142
Entity Type Code : Organization
Provider Name (Legal Business Name) : DMB MEDICAL MANAGEMENT LLC
Provider Business Mailing Address
First Line : 2715 FANNIN ST STE A
Second Line :
City : HOUSTON
State : TX
Zip : 77002-9217
Country : US
Telephone Number : 281-501-0853
Fax Number : 281-501-0882
Provider Business Practice Location Address
First Line : 2715 FANNIN ST STE A
Second Line :
City : HOUSTON
State : TX
Zip : 77002-9217
Country : US
Telephone Number : 281-501-0853
Fax Number : 281-501-0882
Authorized Official
Title or Position : OWNER
Name : PHILANA BOYD
Credential : FNP-C
Telephone Number : 281-501-0853
Provider Enumeration Date : 10/23/2017
Last Update Date : 06/16/2018

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Directions to “DMB MEDICAL MANAGEMENT LLC ” Practice Location

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