| NPI | 1053623645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON CLARK National Contract Mgr. 512-806-2879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: FL 1313643) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2022-05-27 |