1649062837 NPI number — MR. AFSHIN MOTALEBI SOLE PROPRIETOR

Table of content: MR. AFSHIN MOTALEBI SOLE PROPRIETOR (NPI 1649062837)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649062837 NPI number — MR. AFSHIN MOTALEBI SOLE PROPRIETOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOTALEBI
Provider First Name:
AFSHIN
Provider Middle Name:
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
SOLE PROPRIETOR
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOTALEBI
Provider Other First Name:
AFSHIN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
UNITED HOME MEDICAL
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1649062837
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
711 N BELL BLVD.
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
CEDAR PARK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78613-2209
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-686-8866
Provider Business Mailing Address Fax Number:
512-686-8866

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
711 N BELL BLVD STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDAR PARK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78613-2209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-686-8866
Provider Business Practice Location Address Fax Number:
512-686-8866
Provider Enumeration Date:
05/21/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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