| NPI | 1053697698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAYRA REYNA Owner/Operator 817-240-9208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2011-10-27 |