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General NPI Number Information
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NPI Number | 1184766032
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Entity Type | Organization
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Legal Business Name | SEALY MEDSUP GROUP
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3137 N. HWY 36 SUITE 5
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City | SEALY
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State | TX
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Zip | 77474
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Country | US
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Telephone | 979-885-1999
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Fax | 713-995-1806
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Provider Business Mailing Address
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Address Line | 3137 N. HWY 36 SUITE 5
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City | SEALY
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State | TX
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Zip | 77474
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Country | US
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Telephone | 979-885-1999
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Fax | 713-995-1806
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Authorized Official
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Title or Position | CEO
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Name | MR. OLUSOJI TEMIDIRE OLUSANYA
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Credential |
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Telephone | 979-885-1999
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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 |
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License Number State |
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