| NPI | 1649594870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAN JUANITA MARTINEZ Shoe Fitter 956-775-7832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 32021418402) |
| Enumeration Date | 2010-03-17 |
| Last Update Date | 2011-01-11 |