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General NPI Number Information
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NPI Number | 1457358038
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Entity Type | Organization
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Legal Business Name | CHEST DIAGNOSTIC THERAPEUTIC SVCS & TRANSIT NURSING OF TX, INC
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Dates
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Enumeration Date | 06/28/2005
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Last Update Date | 07/16/2010
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Provider Practice Location Address
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Address Line | 903 S BECKHAM AVE
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City | TYLER
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State | TX
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Zip | 75701-1907
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Country | US
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Telephone | 903-596-9565
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Fax | 903-592-0114
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Provider Business Mailing Address
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Address Line | PO BOX 289
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City | MEXIA
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State | TX
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Zip | 76667-0289
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Country | US
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Telephone | 254-562-3803
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Fax | 254-562-2372
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MR. WILLIAM H WRAGGE
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Credential | RRT
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Telephone | 254-562-3803
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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 | 0085076
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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 | 0085076
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License Number State | TX
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