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General NPI Number Information
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NPI Number | 1356590277
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Entity Type | Organization
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Legal Business Name | AGI D M E INC
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/24/2014
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Provider Practice Location Address
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Address Line | 15600 SAN PEDRO AVE SUITE 203
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City | SAN ANTONIO
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State | TX
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Zip | 78232-3740
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Country | US
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Telephone | 210-858-2040
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Fax |
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Provider Business Mailing Address
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Address Line | 15600 SAN PEDRO AVE SUITE 203
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City | SAN ANTONIO
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State | TX
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Zip | 78232-3740
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Country | US
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Telephone | 210-858-2040
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | RAFAEL TOMAS ORELLANA
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Credential |
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Telephone | 210-858-2040
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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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