Provider Demographics
NPI:1922189083
Name:MOBILE MEDICAL SERVICES, LLP
Entity type:Organization
Organization Name:MOBILE MEDICAL SERVICES, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NISHA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-319-7981
Mailing Address - Street 1:5109 82ND ST
Mailing Address - Street 2:UNIT 7, PMB 244
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-3000
Mailing Address - Country:US
Mailing Address - Phone:806-319-7981
Mailing Address - Fax:806-281-0360
Practice Address - Street 1:3602 24TH STREET
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410
Practice Address - Country:US
Practice Address - Phone:806-281-0499
Practice Address - Fax:806-281-0360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX247100000X
335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
No247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX086104902Medicaid
TX459865OtherBC/BS PROVIDER ID
TX086104902Medicaid
TX086104902Medicaid