MEDICARE: VON HOOKS

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1992240089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VON HOOKS

Provider Business Mailing Address
First Line	:	4000 DYER ST
Second Line	:	SUITE I
City	:	EL PASO
State	:	TX
Zip	:	79930-6663
Country	:	US
Telephone Number	:	253-632-5587
Fax Number	:

Provider Business Practice Location Address
First Line	:	45015 2ND CAVALRY CIR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-4322
Country	:	US
Telephone Number	:	253-632-5587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2016
Last Update Date	:	12/27/2016

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Directions to “ VON HOOKS ” Practice Location

Language	Start Address	Practice Location

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