Healthcare Provider Details

I. General information

NPI: 1609366467
Provider Name (Legal Business Name): RGV BIOMED XPRESS DME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2018
Last Update Date: 05/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N TEXAS AVE
MERCEDES TX
78570-2754
US

IV. Provider business mailing address

150 N TEXAS AVE
MERCEDES TX
78570-2754
US

V. Phone/Fax

Practice location:
  • Phone: 956-261-0424
  • Fax:
Mailing address:
  • Phone: 956-261-0424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAZMIN CANDANOZA
Title or Position: OWNER
Credential:
Phone: 956-261-0424