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General NPI Number Information
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NPI Number | 1487739967
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Entity Type | Organization
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Legal Business Name | PRAISE DME SUPPLIES
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 6201 BONHOMME RD 187N
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City | HOUSTON
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State | TX
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Zip | 77036-4365
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Country | US
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Telephone | 713-972-9149
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Fax | 713-972-9151
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Provider Business Mailing Address
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Address Line | 6201 BONHOMME RD 187N
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City | HOUSTON
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State | TX
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Zip | 77036-4365
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Country | US
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Telephone | 713-972-9149
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Fax | 713-972-9151
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Authorized Official
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Title or Position | ADMINISTRATION
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Name | EKPEDEME OBOT
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Credential |
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Telephone | 713-972-9149
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 0077954
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License Number State | TX
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