Provider Demographics
NPI:1124551148
Name:ADAPTIVE MOBILITY OF THE S/W
Entity type:Organization
Organization Name:ADAPTIVE MOBILITY OF THE S/W
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-235-0670
Mailing Address - Street 1:1709 LOUELLA CT
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3722
Mailing Address - Country:US
Mailing Address - Phone:817-235-0670
Mailing Address - Fax:817-704-3184
Practice Address - Street 1:1709 LOUELLA CT
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3722
Practice Address - Country:US
Practice Address - Phone:817-235-0670
Practice Address - Fax:817-704-3184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty