| NPI | 1265769236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMARCO FORTEZ ALLEN Owner 972-329-1543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 200900313211) |
| Enumeration Date | 2009-11-11 |
| Last Update Date | 2009-11-11 |