Healthcare Provider Details

I. General information

NPI: 1114329547
Provider Name (Legal Business Name): BT MEDICAL SUPPLIE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2014
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 E GARLAND ST
GRAND SALINE TX
75140-1984
US

IV. Provider business mailing address

201 LINDA DR
SULPHUR SPRINGS TX
75482-4354
US

V. Phone/Fax

Practice location:
  • Phone: 903-885-8700
  • Fax: 903-885-8711
Mailing address:
  • Phone: 903-962-0371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WILLIAM NOEL HOLDEN
Title or Position: OWNER
Credential:
Phone: 903-885-8700