| NPI | 1184721391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSELYN JACK President 817-299-0297 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TX 0088916) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 0088916) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-07-15 |