| NPI | 1255323671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | B J EKANEM Owner 817-923-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0060761) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0060761) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2020-08-22 |