1912539990 NPI number — SABA INTERNATIONAL INC

Table of content: KATELYNN MASTROROCCO MURRAY PT, DPT (NPI 1821765488)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912539990 NPI number — SABA INTERNATIONAL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SABA INTERNATIONAL INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912539990
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9229 BLUE WATER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75025-6535
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
469-540-0266
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4740 14TH ST # T-320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLANO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75074-7316
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-540-0266
Provider Business Practice Location Address Fax Number:
469-409-4060
Provider Enumeration Date:
02/07/2020

Additional Information

Authorized Official

Authorized Official Last Name:
MALIK
Authorized Official First Name:
FAISAL
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO & CO-FOUNDER
Authorized Official Telephone Number:
469-540-0266

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 019852 . This is a "HUMAN HEALTH SERVICES COMMISSION OF TEXAS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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