| NPI | 1760728745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVASA TALLA Member 956-399-2453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 26981) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: TX 26981) |
| Enumeration Date | 2012-12-20 |
| Last Update Date | 2021-07-09 |