Healthcare Provider Details

I. General information

NPI: 1013938281
Provider Name (Legal Business Name): CAS MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 W IRVING BLVD
IRVING TX
75061-4233
US

IV. Provider business mailing address

2600 W IRVING BLVD
IRVING TX
75061-4233
US

V. Phone/Fax

Practice location:
  • Phone: 214-329-6414
  • Fax: 214-432-0290
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. CHUCK ALFRED IJIOMA
Title or Position: COO
Credential:
Phone: 214-329-6414