| NPI | 1194890525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUSTINE OSCAR UKPONG Owner 817-557-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0063776) |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-08-22 |