| NPI | 1053653550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR FRAGOSO Owner 210-859-5438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 1001051) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |