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General NPI Number Information
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NPI Number | 1174741300
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Entity Type | Organization
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Legal Business Name | JTW MEDICAL PRODUCTS, INC.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 03/06/2008
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Provider Practice Location Address
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Address Line | 5228 W PLANO PKWY
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City | PLANO
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State | TX
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Zip | 75093-5005
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Country | US
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Telephone | 972-250-5738
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Fax |
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Provider Business Mailing Address
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Address Line | 4760 PRESTON RD SUITE 244-289
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City | FRISCO
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State | TX
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Zip | 75034-8548
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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 | MR. JOHN THOMAS WALL III
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Credential |
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Telephone | 214-325-5679
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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 | 0040198
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License Number State | TX
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