Healthcare Provider Details

I. General information

NPI: 1720109093
Provider Name (Legal Business Name): LA PALOMA DME,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2336 E. GRANT STREET SUITE #1
ROMA TX
78584
US

IV. Provider business mailing address

2336 E. GRANT STREET SUITE #1
ROMA TX
78584
US

V. Phone/Fax

Practice location:
  • Phone: 956-846-5586
  • Fax: 956-849-5528
Mailing address:
  • Phone: 956-846-5586
  • Fax: 956-849-5528

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: CARMEN ENID PEREZ
Title or Position: OWNER
Credential:
Phone: 956-849-5586