Healthcare Provider Details

I. General information

NPI: 1245293992
Provider Name (Legal Business Name): M P HEALTHCARE MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2006
Last Update Date: 09/05/2024
Certification Date: 09/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 E RAMSEY RD
SAN ANTONIO TX
78216-4607
US

IV. Provider business mailing address

224 E RAMSEY RD
SAN ANTONIO TX
78216-4607
US

V. Phone/Fax

Practice location:
  • Phone: 713-864-1111
  • Fax: 713-864-5215
Mailing address:
  • Phone: 713-864-1111
  • Fax: 713-864-5215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: BETHANY CALLAWAY
Title or Position: OFFICE MANAGER
Credential:
Phone: 713-864-1111