Healthcare Provider Details

I. General information

NPI: 1770589392
Provider Name (Legal Business Name): CHEST DIAGNOSTIC THERAPEUTIC SVCS & TRANSIT NURSING OF TX, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 05/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E MILAM ST
MEXIA TX
76667-2329
US

IV. Provider business mailing address

PO BOX 289
MEXIA TX
76667-0289
US

V. Phone/Fax

Practice location:
  • Phone: 254-562-3803
  • Fax: 254-562-2372
Mailing address:
  • Phone: 254-562-3803
  • Fax: 254-562-2372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0010805
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License NumberATP 915
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number1000005
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number1000552
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1000552
License Number StateTX

VIII. Authorized Official

Name: MR. WILLIAM H WRAGGE
Title or Position: OWNER/CEO
Credential: RRT
Phone: 254-562-3803