Healthcare Provider Details

I. General information

NPI: 1972906790
Provider Name (Legal Business Name): BETTER VARIETY MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2014
Last Update Date: 10/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4512 1ST ST
BACLIFF TX
77518-1600
US

IV. Provider business mailing address

4512 1ST ST
BACLIFF TX
77518-1600
US

V. Phone/Fax

Practice location:
  • Phone: 832-955-7727
  • Fax: 832-218-4285
Mailing address:
  • Phone: 832-955-7727
  • Fax: 832-218-4285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1001422
License Number StateTX

VIII. Authorized Official

Name: JOADANI PAREDES BUSTAMANTE
Title or Position: CEO
Credential:
Phone: 832-955-7727