Healthcare Provider Details

I. General information

NPI: 1841761806
Provider Name (Legal Business Name): E-AUTHORITY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 12/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 WEST VAN ALSTYNE PARKWAY SUITE 6
VAN ALSTYNE TX
75495
US

IV. Provider business mailing address

504 DARTMOUTH DR
VAN ALSTYNE TX
75495-7029
US

V. Phone/Fax

Practice location:
  • Phone: 469-712-5322
  • Fax: 469-519-0303
Mailing address:
  • Phone: 214-551-0261
  • Fax: 469-519-0303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL POLLOCK
Title or Position: PRESIDENT
Credential:
Phone: 214-551-0261