| Mip Svc Llc | |
|
2200 North Loop W Ste 106 Houston TX 77018-1754 | |
| (832) 219-8536 | |
| Not Available |
| Full Name | Mip Svc Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2200 North Loop W Ste 106, Houston, Texas |
| Authorized Official Name and Position | Dina Kushaliyeva (CO-FOUNDER) |
| Authorized Official Contact | 2148020224 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mip Svc Llc 2200 North Loop W Ste 106 Houston TX 77018-1754 Ph: (832) 219-8536 | Mip Svc Llc 2200 North Loop W Ste 106 Houston TX 77018-1754 Ph: (832) 219-8536 |
| NPI Number | 1063288512 |
|---|---|
| Provider Enumeration Date | 11/27/2023 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Medicare PECOS PAC ID | 3173974607 |
|---|---|
| Medicare Enrollment ID | O20240109004941 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063288512 | NPI | - | NPPES |
| Provider Name | Le Q Vo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538363130 PECOS PAC ID: 5799969226 Enrollment ID: I20140128001489 |
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