MEDICARE: TANGLEWOOD MEDICAL SUPPLIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332BX2000X	Oxygen Equipment & Supplies (DME)
4	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1144259904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TANGLEWOOD MEDICAL SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	2445 ROBERT J GLASGOW LOOP
Second Line	:	STE B
City	:	STEPHENVILLE
State	:	TX
Zip	:	76401-1705
Country	:	US
Telephone Number	:	254-968-6999
Fax Number	:	254-968-6167

Provider Business Practice Location Address
First Line	:	5940 LOWER BIRDVILLE RD UNIT B3
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76117-5708
Country	:	US
Telephone Number	:	817-244-1105
Fax Number	:	254-968-6167

Authorized Official
Title or Position	:	DIRECTOR
Name	:	EDMUND CASE HORTON
Credential	:
Telephone Number	:	254-968-6999

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	01/13/2025

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