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General NPI Number Information
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NPI Number | 1497092357
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Entity Type | Organization
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Legal Business Name | C3MJ MEDICAL SUPPLIES
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Dates
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Enumeration Date | 01/12/2013
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Last Update Date | 01/12/2013
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Provider Practice Location Address
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Address Line | 11651 WREN CROSSING DR
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City | HOUSTON
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State | TX
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Zip | 77038-3616
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Country | US
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Telephone | 832-452-7599
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Fax | 281-999-1340
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Provider Business Mailing Address
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Address Line | 11651 WREN CROSSING DR
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City | HOUSTON
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State | TX
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Zip | 77038-3616
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Country | US
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Telephone | 832-452-7599
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Fax | 281-999-1340
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Authorized Official
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Title or Position | OWNER
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Name | JULIA DAVENPORT HAWKINS
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Credential |
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Telephone | 832-452-7599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State | TX
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