| NPI | 1750320123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LEWIS EVP Of Licensure 512-806-2756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
| Additional Taxonomies | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition |
| 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 332BX2000X Durable Medical Equipment & Medical Supplies Oxygen Equipment & Supplies | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2025-09-22 |