| NPI | 1255769014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY WILLIAMS General Manager 915-599-1129 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2013-10-14 |