Healthcare Provider Details

I. General information

NPI: 1497703094
Provider Name (Legal Business Name): OXYPRO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

902 N BRIDGE ST
BRADY TX
76825-4015
US

IV. Provider business mailing address

8307 VENITA AVE
LUBBOCK TX
79424-4915
US

V. Phone/Fax

Practice location:
  • Phone: 325-792-1060
  • Fax:
Mailing address:
  • Phone: 806-866-9966
  • Fax: 806-866-2805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0060517
License Number StateTX

VIII. Authorized Official

Name: MR. KELLY PAUL MCELHANEY
Title or Position: PRESIDENT
Credential:
Phone: 806-866-9966