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Organization
MEDIVANTA LLC
Active
Organization
MEDIVANTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED SHAMOON ALI (OWNER)
(818) 664-8316
Entity
Organization
Contact information
Practice address
1709 MEADOWLEAF LN, WYLIE, TX 75098-0345
(818) 664-8316
Mailing address
1709 MEADOWLEAF LN, WYLIE, TX 75098-0345
(818) 664-8316
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
08/21/2026
Last updated
08/21/2026
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