Provider Demographics
NPI:1861162455
Name:MJSG LLC
Entity type:Organization
Organization Name:MJSG LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUNIB
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-416-5312
Mailing Address - Street 1:11251 RICHMOND AVE STE F107
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2675
Mailing Address - Country:US
Mailing Address - Phone:281-416-5312
Mailing Address - Fax:
Practice Address - Street 1:11251 RICHMOND AVE STE F107
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2675
Practice Address - Country:US
Practice Address - Phone:281-416-5312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-15
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory