| NPI | 1417902578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAKE HALLSTED President 832-448-3705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 332BP3500X) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-08-22 |