# MIMO MEDICAL SERVICES, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871107474
- **Authorized official:** MATHIAS GROGUHE (MANAGING EMPLOYEE)
- **Authorized official phone:** (512) 201-6766

## Contact information

- **Practice address:** 2506 CRESTVIEW DR, MAGNOLIA, AR 71753-4336
- **Practice address phone:** (479) 530-1308
- **Practice address fax:** (479) 968-1673
- **Mailing address:** PO BOX 9178, RUSSELLVILLE, AR 72811-9178
- **Mailing address phone:** (800) 824-4094
- **Mailing address fax:** (479) 968-1673

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/02/2020
- **Last updated:** 02/25/2026