Healthcare Provider Details

I. General information

NPI: 1902145709
Provider Name (Legal Business Name): RELIANT MEDGROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

526 E HWY 120 STE. 6
POTTSBORO TX
75076-3574
US

IV. Provider business mailing address

526 E HWY 120 STE. 6
POTTSBORO TX
75076-3574
US

V. Phone/Fax

Practice location:
  • Phone: 903-771-0066
  • Fax: 888-790-5509
Mailing address:
  • Phone: 903-771-0066
  • Fax: 888-790-5509

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: JEFF LIGHTFOOT
Title or Position: CONSULTANT
Credential:
Phone: 903-771-0066