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General NPI Number Information
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NPI Number | 1003383019
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Entity Type | Organization
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Legal Business Name | SAN JOSE DME LLC
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Dates
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Enumeration Date | 10/28/2018
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Last Update Date | 04/19/2024
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Provider Practice Location Address
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Address Line | 1005 E 10TH ST STE B
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City | WESLACO
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State | TX
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Zip | 78596-5133
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Country | US
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Telephone | 956-801-2065
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Fax | 956-435-9253
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Provider Business Mailing Address
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Address Line | 1005 E 10TH ST STE B
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City | WESLACO
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State | TX
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Zip | 78596-5133
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Country | US
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Telephone | 956-801-2065
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE SALINAS
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Credential |
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Telephone | 956-801-2065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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