| NPI | 1417160441 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYNA GENTRY Billing Agent 817-987-1466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2020-08-22 |