Provider Demographics
NPI:1144596040
Name:NORTH TEXAS 101 MOBILITY LLC
Entity type:Organization
Organization Name:NORTH TEXAS 101 MOBILITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GORDON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:RANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-455-3716
Mailing Address - Street 1:2712 MILTON AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-1521
Mailing Address - Country:US
Mailing Address - Phone:214-455-3716
Mailing Address - Fax:
Practice Address - Street 1:797 N GROVE RD
Practice Address - Street 2:SUITE 113
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6207
Practice Address - Country:US
Practice Address - Phone:214-455-3716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-26
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies