MEDICARE: IMMEDIATE MEDICAL EQUIPMENT PROVIDERS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1356408504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMMEDIATE MEDICAL EQUIPMENT PROVIDERS

Provider Business Mailing Address
First Line	:	2616 SOUTH LOOP W
Second Line	:	SUITE 594
City	:	HOUSTON
State	:	TX
Zip	:	77054-2662
Country	:	US
Telephone Number	:	866-950-4637
Fax Number	:	713-592-0800

Provider Business Practice Location Address
First Line	:	2616 SOUTH LOOP W
Second Line	:	SUITE 594
City	:	HOUSTON
State	:	TX
Zip	:	77054-2662
Country	:	US
Telephone Number	:	866-950-4637
Fax Number	:	713-592-0800

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. YOLANDA G GONZALES
Credential	:
Telephone Number	:	504-450-7600

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	08/22/2020

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