Healthcare Provider Details

I. General information

NPI: 1124995089
Provider Name (Legal Business Name): GOLDEN HEART MEDICAL SUPPLIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 SAM BASS RD STE 500A
ROUND ROCK TX
78681-1801
US

IV. Provider business mailing address

2111 SAM BASS RD STE 500A
ROUND ROCK TX
78681-1801
US

V. Phone/Fax

Practice location:
  • Phone: 512-879-4155
  • Fax: 512-788-9585
Mailing address:
  • Phone: 512-879-4155
  • Fax: 512-788-9585

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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: CATHARINE OOSTDAM
Title or Position: OWNER
Credential:
Phone: 512-879-4155