Provider Demographics
NPI:1619779261
Name:MEDULLA INC.
Entity type:Organization
Organization Name:MEDULLA INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MUZZUMMIL
Authorized Official - Middle Name:PERVAIZ
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DR
Authorized Official - Phone:832-525-3533
Mailing Address - Street 1:6430 RICHMOND AVE SUITE #275
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-5917
Mailing Address - Country:US
Mailing Address - Phone:835-230-0046
Mailing Address - Fax:
Practice Address - Street 1:6430 RICHMOND AVE SUITE #275
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5917
Practice Address - Country:US
Practice Address - Phone:835-230-0046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies