| NPI | 1598486631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHALIL SHAFIQ Authorized Offical 512-750-4858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2023-09-13 |