Healthcare Provider Details

I. General information

NPI: 1538946520
Provider Name (Legal Business Name): CPR DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 10/17/2023
Certification Date: 10/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N BONHAM ST STE 6
SAN BENITO TX
78586-0097
US

IV. Provider business mailing address

900 N BONHAM ST STE 6
SAN BENITO TX
78586-0097
US

V. Phone/Fax

Practice location:
  • Phone: 956-241-0408
  • Fax:
Mailing address:
  • Phone: 956-241-0408
  • Fax:

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: GABRIEL COLMENERO
Title or Position: OWNER
Credential:
Phone: 956-241-0408