OM PREMIUM LLC NPI 1841942851

NPI Information

OM PREMIUM LLC is a clinic center in Dallas, TX. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). OM PREMIUM LLC NPI is 1841942851. The provider is registered as an organization entity type.

The provider's business location address is:

12700 HILLCREST RD STE 125
DALLAS, TX
ZIP 75230-009
Phone: (945) 345-9922

The provider's authorized official is Mohammed Mujeeb .
The authorized official title is President and has the following contact phone number (945) 245-9922.

The CLIA number assigned to this NPI record is 45D2249428 - ancillary test site with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/20/2022 and was last updated on 1/20/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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