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General NPI Number Information
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NPI Number | 1215190392
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Entity Type | Organization
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Legal Business Name | WALDREP MEDICAL
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Dates
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Enumeration Date | 07/08/2008
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Last Update Date | 07/08/2008
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Provider Practice Location Address
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Address Line | 330 OAKS TRL SUITE 108
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City | GARLAND
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State | TX
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Zip | 75043-4083
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Country | US
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Telephone | 972-203-3030
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Fax | 972-203-5566
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Provider Business Mailing Address
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Address Line | 330 OAKS TRL SUITE 108
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City | GARLAND
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State | TX
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Zip | 75043-4083
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Country | US
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Telephone | 972-203-3030
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Fax | 972-203-5566
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID JAMES PRINCE JR.
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Credential |
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Telephone | 972-203-3030
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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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