Organization Name: | MBA GENERAL MANAGEMENT LTD |
NPI Number: | 1659558104 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICARDO A ROCHA (SR. PARTNER) |
Mailing Address: | 3330 Douglas Ave Dallas |
State: | TX US |
Postal Code: | 752192717 |
Phone Number: | 2145223930 |
Fax Number: | 2145227338 |
NPI Enumeration Date: | 01/28/2008 |
NPI Last Update Date: | 01/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | D3385 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |