| NPI | 1902271935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI FULLER Administrator 512-485-7208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX J7566) |
| Enumeration Date | 2015-12-02 |
| Last Update Date | 2021-09-30 |