| NPI | 1003134396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK D JACKSON President 972-408-6831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2010-05-11 |