Healthcare Provider Details

I. General information

NPI: 1417640574
Provider Name (Legal Business Name): BROOK FOREST DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2023
Last Update Date: 12/17/2024
Certification Date: 12/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27347 W HARDY RD STE 314
SPRING TX
77373-2106
US

IV. Provider business mailing address

27347 W HARDY RD STE 314
SPRING TX
77373-2106
US

V. Phone/Fax

Practice location:
  • Phone: 713-836-1905
  • Fax: 281-720-8087
Mailing address:
  • Phone: 713-836-1905
  • Fax: 281-720-8087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAUL MESSER
Title or Position: MANAGER
Credential: JD
Phone: 808-356-9048