=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356492938
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ECONO MED
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/12/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 N MCCOLL RD SUITE C2
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78501-9362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-631-5522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 N MCCOLL RD SUITE C2
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78501-9362
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-631-5522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRINCIPAL
-----------------------------------------------------
Name | GENARO MUNOZ III
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-631-5522
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 0065980
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------