| NPI | 1891286365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA L SCOTT Delegated Official 832-454-2848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: TX 1001446) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 1001425) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |