| NPI | 1215934690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA MARIE PETERSON President 210-375-0003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TX 0063893) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 1004576) |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 0063893) | |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0063893) | |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0063893) | |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2009-05-14 |