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Individual

JABRILL OMAR JIMAALE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5725 E LANCASTER AVE, FORT WORTH, TX 76112-6528
(817) 851-1663
(817) 851-1664
Mailing address
5725 E LANCASTER AVE, FORT WORTH, TX 76112-6528
(817) 851-1663
(817) 851-1664

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
T950225934414
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
842077605
NON EMERGENCY MEDICAL TRANSPORTATION
TX
Enumeration date
02/06/2020
Last updated
02/06/2020
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