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General NPI Number Information
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NPI Number | 1518044916
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Entity Type | Organization
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Legal Business Name | PROFICIENT CARE MEDICAL SUPPLIES
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1747 CITADELL PLZ STE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1017
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Country | US
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Telephone | 210-829-4106
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Fax | 210-829-4101
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Provider Business Mailing Address
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Address Line | 7126 WOODGATE DR
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City | SAN ANTONIO
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State | TX
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Zip | 78227-1937
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Country | US
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Telephone | 210-375-5741
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. TRINIDAD MOLINA III
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Credential |
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Telephone | 210-829-4106
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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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