Healthcare Provider Details

I. General information

NPI: 1821203324
Provider Name (Legal Business Name): HOUSTON PREMIER DME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 E. SOUTHMORE AVE SUITE 206
PASADENA TX
77502-1130
US

IV. Provider business mailing address

817 E. SOUTHMORE AVE SUITE 206
PASADENA TX
77502-1130
US

V. Phone/Fax

Practice location:
  • Phone: 713-477-4200
  • Fax: 713-477-4204
Mailing address:
  • Phone: 713-477-4200
  • Fax: 713-477-4204

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 Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ATILANO SERNA
Title or Position: PRESIDENT
Credential:
Phone: 713-477-4200