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General NPI Number Information
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NPI Number | 1174636559
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Entity Type | Organization
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Legal Business Name | DMEDICUS LLC
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/24/2007
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Provider Practice Location Address
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Address Line | 108 E RUSK ST # 103
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City | ROCKWALL
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State | TX
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Zip | 75087-3725
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Country | US
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Telephone | 469-698-0250
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 LAKE GLEN CIR
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City | ROCKWALL
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State | TX
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Zip | 75087-6009
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Country | US
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Telephone | 469-698-8806
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Fax | 469-698-8816
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BYRLE WILLIAM DARLAND JR.
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Credential |
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Telephone | 469-698-9939
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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 | 0071495
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License Number State | TX
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