| NPI | 1104095363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD BRIAN MCCOOL Podiatrist 915-581-1133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0916) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2013-06-11 |