| NPI | 1780614404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEBAYO ADEBOLA Administrator 281-298-4014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies Parenteral & Enteral Nutrition (Licence: TX 0065860) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: TX 0065860) |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2008-09-02 |