Organization
A24 TRANSPORTATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOSHREG TAHA MUSTAFA VI OWNER (MD)
(469) 642-6517
Entity
Organization
Contact information
Practice address
12611 HORNBEAM DR, DALLAS, TX 75243-2607
(469) 642-6517
Mailing address
12611 HORNBEAM DR, DALLAS, TX 75243-2607
(469) 642-6517
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
TX
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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