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General NPI Number Information
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NPI Number | 1215117239
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Entity Type | Organization
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Legal Business Name | RENJI JOHN
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 3016 S SHILOH RD
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City | GARLAND
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State | TX
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Zip | 75041-2415
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Country | US
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Telephone | 214-227-4353
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Fax | 214-227-4356
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Provider Business Mailing Address
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Address Line | 922 MYERS MEADOW DR
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City | GARLAND
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State | TX
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Zip | 75043-3711
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Country | US
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Telephone | 214-227-4353
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Fax | 214-227-5356
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Authorized Official
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Title or Position | OWNNER/C.E.O
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Name | RENJI JOHN
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Credential |
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Telephone | 214-227-4353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0073430
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License Number State | TX
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Taxonomy #2
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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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