Healthcare Provider Details

I. General information

NPI: 1265387856
Provider Name (Legal Business Name): REALMED SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25807 WESTHEIMER PKWY STE 351
KATY TX
77494-5370
US

IV. Provider business mailing address

25807 WESTHEIMER PKWY STE 351
KATY TX
77494-5370
US

V. Phone/Fax

Practice location:
  • Phone: 346-586-4493
  • Fax: 346-396-2256
Mailing address:
  • Phone: 346-586-4493
  • Fax: 346-396-2256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: HANIF M GHANCHI
Title or Position: OWNER
Credential: OWNER
Phone: 346-396-1252