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General NPI Number Information
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NPI Number | 1164827978
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Entity Type | Organization
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Legal Business Name | TEXAS DURABLE MEDICAL EQUIPMENT, INC
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 5235 SOUTHMOST RD SUITE D
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City | BROWNSVILLE
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State | TX
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Zip | 78521-8052
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Country | US
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Telephone | 956-525-4616
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 830526
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City | SAN ANTONIO
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State | TX
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Zip | 78283-0526
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTONIO DAVILA
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Credential | RN, CPED
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Telephone | 210-462-6211
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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 | CPED1199
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License Number State | TX
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