Healthcare Provider Details

I. General information

NPI: 1306456157
Provider Name (Legal Business Name): CONQUEST DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12929 JESS PIRTLE BLVD STE 250
SUGAR LAND TX
77478-2851
US

IV. Provider business mailing address

12929 JESS PIRTLE BLVD STE 250
SUGAR LAND TX
77478-2851
US

V. Phone/Fax

Practice location:
  • Phone: 281-637-2221
  • Fax:
Mailing address:
  • Phone: 281-637-2221
  • 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: JANE WILKERSON-BUNCH
Title or Position: CEO
Credential:
Phone: 770-366-0644