Healthcare Provider Details

I. General information

NPI: 1396719621
Provider Name (Legal Business Name): HERMANN MEDICAL SUPPLIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 03/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 MASON PARK BLVD SUITE A
KATY TX
77450-6242
US

IV. Provider business mailing address

439 MASON PARK BLVD SUITE A
KATY TX
77450-6242
US

V. Phone/Fax

Practice location:
  • Phone: 281-392-1114
  • Fax: 281-392-1146
Mailing address:
  • Phone: 281-392-1114
  • Fax: 281-392-1146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberTX 0012914
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0080003
License Number StateTX

VIII. Authorized Official

Name: ABIGAIL GREENE
Title or Position: PRESIDENT
Credential:
Phone: 281-392-1114