| NPI | 1144430661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY MAYES System Administrator 817-457-8324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |