| NPI | 1396748836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ALAN BACCUS President/Owner 940-591-1496 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0030844) |
| Enumeration Date | 2005-05-28 |
| Last Update Date | 2020-08-22 |