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General NPI Number Information
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NPI Number | 1194001495
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Entity Type | Organization
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Legal Business Name | EZ LIFE MEDICAL SUPPLIES
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 10/31/2011
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Provider Practice Location Address
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Address Line | 101 S COIT RD
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City | RICHARDSON
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State | TX
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Zip | 75080-5743
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Country | US
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Telephone | 214-450-0295
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Fax | 214-570-1620
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Provider Business Mailing Address
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Address Line | 4697 GLEN HEATHER DR
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City | FRISCO
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State | TX
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Zip | 75034-2185
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Country | US
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Telephone | 214-415-2914
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Fax | 214-570-1620
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Authorized Official
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Title or Position | ORGANIZOR
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Name | MR. HOSS RAVANDI
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Credential |
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Telephone | 214-450-0295
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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 | TX
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