Healthcare Provider Details

I. General information

NPI: 1033755897
Provider Name (Legal Business Name): GRATZ DURABLE MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 01/17/2020
Certification Date: 01/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 REGENCY SQUARE BLVD STE 252
HOUSTON TX
77036-3186
US

IV. Provider business mailing address

11530 SLICK ROCK DR
RICHMOND TX
77406-1470
US

V. Phone/Fax

Practice location:
  • Phone: 508-410-0512
  • Fax:
Mailing address:
  • Phone: 508-410-0512
  • Fax: 281-783-6558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. EZE JOHN
Title or Position: DIRECTOR
Credential:
Phone: 508-410-0512