Healthcare Provider Details

I. General information

NPI: 1124945613
Provider Name (Legal Business Name): LUCKY MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

695 PINELOCH DR APT 1208
WEBSTER TX
77598-1853
US

IV. Provider business mailing address

695 PINELOCH DR APT 1208
WEBSTER TX
77598-1853
US

V. Phone/Fax

Practice location:
  • Phone: 832-285-6205
  • Fax:
Mailing address:
  • Phone: 832-285-6205
  • 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: MR. MUBBASHIR HASSAN
Title or Position: OWNER
Credential:
Phone: 832-285-6205