Organization
MY HOME MD NON PROFIT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEIGH ANN TIPPING (CEO/SECRETARY)
(682) 472-0161
Entity
Organization
Contact information
Practice address
630 N HIGHWAY 67 STE 2, CEDAR HILL, TX 75104-2156
(214) 339-2221
(214) 432-1117
Mailing address
105 E OAK ST STE 103, MANSFIELD, TX 76063-7713
(682) 472-0161
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
L2986
TX
Other
Enumeration date
09/01/2015
Last updated
09/02/2015
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