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General NPI Number Information
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NPI Number | 1124096722
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Entity Type | Organization
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Legal Business Name | MARIA M. SAMUDIA
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 07/31/2009
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Provider Practice Location Address
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Address Line | 1610 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3180
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Country | US
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Telephone | 956-424-3232
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Fax | 956-581-0635
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Provider Business Mailing Address
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Address Line | 1610 E GRIFFIN PKWY
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City | MISSION
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State | TX
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Zip | 78572-3180
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Country | US
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Telephone | 956-424-3232
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Fax | 956-581-0635
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Authorized Official
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Title or Position | OWNER
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Name | MARIA M SAMUDIA
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Credential |
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Telephone | 956-687-9559
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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 | 0087745
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License Number State | TX
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