| NPI | 1811993751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA FORD Interim Administrator 254-803-3561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 000527) |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 000527TX) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2021-06-02 |