| NPI | 1902945967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE HAROLD GARVIN President 903-793-0416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 0028959) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 0028959) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 0028959) | |
| 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 0028959) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2012-01-12 |