Provider Demographics
NPI:1871940171
Name:SAN AN, LLC
Entity type:Organization
Organization Name:SAN AN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-353-3000
Mailing Address - Street 1:4909 NE 28TH ST
Mailing Address - Street 2:
Mailing Address - City:HALTOM CITY
Mailing Address - State:TX
Mailing Address - Zip Code:76117-4412
Mailing Address - Country:US
Mailing Address - Phone:817-831-3237
Mailing Address - Fax:817-831-3235
Practice Address - Street 1:4909 NE 28TH ST
Practice Address - Street 2:
Practice Address - City:HALTOM CITY
Practice Address - State:TX
Practice Address - Zip Code:76117-4412
Practice Address - Country:US
Practice Address - Phone:817-831-3237
Practice Address - Fax:817-831-3235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle