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General NPI Number Information
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NPI Number | 1083796742
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Entity Type | Organization
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Legal Business Name | LONE STAR SCOOTERS OF DENTON, INC.
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 01/25/2008
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Provider Practice Location Address
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Address Line | 1213 PRIMROSE LN STE A
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City | DENTON
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State | TX
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Zip | 76201-2526
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Country | US
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Telephone | 940-898-8800
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Fax | 940-898-8802
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Provider Business Mailing Address
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Address Line | 1213 PRIMROSE LN STE A
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City | DENTON
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State | TX
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Zip | 76201-2526
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Country | US
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Telephone | 940-898-8800
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Fax | 940-898-8802
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. BRADLEYM MICHAEL SMITH
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Credential |
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Telephone | 940-898-8800
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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 | 0072871
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License Number State | TX
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