| NPI | 1578517488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA L RUSSELL President 361-808-7382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0041403) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 0041403) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0041403) | |
| 171W00000X Contractor | |
| 171WH0202X Contractor, Home Modifications | |
| 171WV0202X Contractor, Vehicle Modifications | |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2016-09-14 |