Healthcare Provider Details

I. General information

NPI: 1790843696
Provider Name (Legal Business Name): BEXAR DURABLE MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 SEGUIN RD 3
SAN ANTONIO TX
78219-1001
US

IV. Provider business mailing address

5020 SEQUIN RD 3
SAN ANTONIO TX
78219-1016
US

V. Phone/Fax

Practice location:
  • Phone: 210-822-3048
  • Fax: 210-822-3587
Mailing address:
  • Phone: 210-822-3048
  • Fax: 210-822-3587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0076226
License Number StateTX

VIII. Authorized Official

Name: MR. ROBERT H ROMERO
Title or Position: CEO
Credential:
Phone: 210-822-3048