Healthcare Provider Details

I. General information

NPI: 1063593143
Provider Name (Legal Business Name): DELTA MEDICAL EQUIPMENT & SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/13/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 WEST EDINBURG AVE
ELSA TX
78543-1059
US

IV. Provider business mailing address

311 WEST EDINBURG AVE P.O. BOX 1059
ELSA TX
78543-1059
US

V. Phone/Fax

Practice location:
  • Phone: 956-262-1900
  • Fax: 956-262-1903
Mailing address:
  • Phone: 956-262-1900
  • Fax: 956-262-1903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0087448
License Number StateTX

VIII. Authorized Official

Name: MR. LEONEL GARZA JR.
Title or Position: PART OWNER
Credential:
Phone: 956-262-1900