Healthcare Provider Details

I. General information

NPI: 1174598064
Provider Name (Legal Business Name): MPS MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 N US HWY 281
LAMPASAS TX
76550-1171
US

IV. Provider business mailing address

1200 N US HWY 281
LAMPASAS TX
76550-1171
US

V. Phone/Fax

Practice location:
  • Phone: 512-556-2323
  • Fax: 512-556-3878
Mailing address:
  • Phone: 512-556-2323
  • Fax: 512-556-3878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0046355
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number0046355
License Number StateTX

VIII. Authorized Official

Name: MR. RAYMOND DWAYNE JONAS
Title or Position: MANAGER
Credential:
Phone: 512-556-2323