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General NPI Number Information
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NPI Number | 1457795148
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Entity Type | Organization
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Legal Business Name | BRAZORIA COUNTY DME INDUSTRIES LLC
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 1217 N VELASCO ST
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City | ANGLETON
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State | TX
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Zip | 77515-3009
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Country | US
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Telephone | 979-849-2900
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Fax | 979-849-2901
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Provider Business Mailing Address
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Address Line | P.O.BOX 1217
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City | ANGLETON
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State | TX
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Zip | 77516-1927
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Country | US
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Telephone | 979-849-2900
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Fax | 979-849-2901
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Authorized Official
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Title or Position | MANAGER/MEMBER
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Name | DR. PLESHETTE B JOHNSON-WIGGINS
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Credential | D.C.
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Telephone | 979-849-2900
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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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