| NPI | 1548205313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDDIE ETTE Business Owner 817-200-2363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 332B00000X) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 0063143) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2011-09-13 |