Healthcare Provider Details
I. General information
NPI: 1184956344
Provider Name (Legal Business Name): TEXAS DURABLE MEDICAL EQUIPMENT, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/12/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2298 N VETERANS BLVD SUITE 1
EAGLE PASS TX
78852-4160
US
IV. Provider business mailing address
113 S COMMERCE ST
DILLEY TX
78017-3501
US
V. Phone/Fax
- Phone: 830-757-5800
- Fax: 830-757-5801
- Phone: 830-965-4900
- Fax: 830-965-4911
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 332B00000X |
| License Number State | TX |
VIII. Authorized Official
Name: MR.
HARVEY
E
COURSER
Title or Position: OWNER
Credential: C PED
Phone: 830-965-4900