| NPI | 1669570172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRETT BEAN Authorized Official/Owner 512-450-4155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0033422) |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0033422) |
| 332BX2000X Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies (Licence: TX 0033422) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2024-09-16 |