Organization
HAYAGRIVA ENTERPRISES LLC
Active
Other names
101 Mobility
Organization subpart
No
Provider details
NPI number
Authorized official
VIKAS NATH MD (OWNER)
(210) 218-1727
Entity
Organization
Contact information
Practice address
416 WAGON WHEEL WAY, CIBOLO, TX 78108-3810
(210) 218-1727
Mailing address
416 WAGON WHEEL WAY, CIBOLO, TX 78108-3810
(210) 218-1727
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598181943
—
MS
Enumeration date
08/28/2020
Last updated
08/29/2020
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