Healthcare Provider Details

I. General information

NPI: 1538445010
Provider Name (Legal Business Name): MVP MEDICAL SUPPLY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2011
Last Update Date: 10/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10764 S GESSNER DR
HOUSTON TX
77071-3509
US

IV. Provider business mailing address

10764 S GESSNER DR
HOUSTON TX
77071-3509
US

V. Phone/Fax

Practice location:
  • Phone: 713-773-4687
  • Fax: 713-773-1687
Mailing address:
  • Phone: 713-773-4687
  • Fax: 713-773-1687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1000558
License Number StateTX

VIII. Authorized Official

Name: FLOYD EARL SWOOPES
Title or Position: OFFICE MANAGER
Credential:
Phone: 713-773-4687