Healthcare Provider Details

I. General information

NPI: 1982909826
Provider Name (Legal Business Name): EVAL'S INCONTINENCE AND DME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2011
Last Update Date: 01/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6209 KINGS BRIDGE DR
EL PASO TX
79934-3021
US

IV. Provider business mailing address

6209 KINGS BRIDGE DR
EL PASO TX
79934-3021
US

V. Phone/Fax

Practice location:
  • Phone: 915-822-1491
  • Fax:
Mailing address:
  • Phone: 915-822-1491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. EDWARD JAMES VALDEZ
Title or Position: OWNER
Credential:
Phone: 915-822-1491