Medivanta LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDIVANTA LLC

Practice address

1709 Meadowleaf LN
Wylie, TX 75098-0345

Phone

(818) 664-8316

NPI assigned

Aug 21, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Syed Shamoon Ali

Title

Owner

Phone

(818) 664-8316

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1787270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787270400000",
    "number": "1861308447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 MEADOWLEAF LN",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750980345",
            "telephone_number": "818-664-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 MEADOWLEAF LN",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750980345",
            "telephone_number": "818-664-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVANTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-21",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A",
        "authorized_official_last_name": "ALI",
        "authorized_official_first_name": "SYED SHAMOON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-664-8316"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Wylie, TX
• Providers in Wylie, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.