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General NPI Number Information
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NPI Number | 1447465497
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Entity Type | Organization
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Legal Business Name | LAREDO MOBILE DME LLC
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Dates
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Enumeration Date | 05/12/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1002 CORPUS CHRISTI ST STE.3
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City | LAREDO
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State | TX
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Zip | 78040-5265
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Country | US
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Telephone | 956-209-4248
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 CORPUS CHRISTI ST STE 3
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City | LAREDO
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State | TX
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Zip | 78040-5265
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Country | US
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Telephone | 956-209-4248
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JUAN HECTOR MARTINEZ
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Credential |
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Telephone | 956-209-4248
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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 |
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License Number State |
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