Provider Demographics
NPI:1366239519
Name:OPTIMA EQUIP LLC
Entity type:Organization
Organization Name:OPTIMA EQUIP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:UNKNOWN
Authorized Official - Middle Name:
Authorized Official - Last Name:FATIMA BEGUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-880-1339
Mailing Address - Street 1:4101 MCEWEN RD STE 526
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-5250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4101 MCEWEN RD STE 368
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-5112
Practice Address - Country:US
Practice Address - Phone:469-880-1339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPTIMA EQUIP LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory