Healthcare Provider Details

I. General information

NPI: 1144259904
Provider Name (Legal Business Name): TANGLEWOOD MEDICAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 01/13/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5940 LOWER BIRDVILLE RD UNIT B3
HALTOM CITY TX
76117-5708
US

IV. Provider business mailing address

2445 ROBERT J GLASGOW LOOP STE B
STEPHENVILLE TX
76401-1705
US

V. Phone/Fax

Practice location:
  • Phone: 817-244-1105
  • Fax: 254-968-6167
Mailing address:
  • Phone: 254-968-6999
  • Fax: 254-968-6167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: EDMUND CASE HORTON
Title or Position: DIRECTOR
Credential:
Phone: 254-968-6999