| NPI | 1902572654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM FALLETTA Licensed Manager 512-396-2124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2021-08-20 |