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General NPI Number Information
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NPI Number | 1548666522
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Entity Type | Organization
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Legal Business Name | EXCLUSIVE MEDICAL SUPPLIES
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Dates
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Enumeration Date | 11/18/2014
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Last Update Date | 11/18/2014
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Provider Practice Location Address
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Address Line | 1303 S ALEXANDER AVE C
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City | DUNCANVILLE
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State | TX
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Zip | 75137-3420
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Country | US
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Telephone | 214-772-3241
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Fax | 214-594-9486
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Provider Business Mailing Address
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Address Line | PO BOX 173153
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City | ARLINGTON
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State | TX
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Zip | 76003-3153
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Country | US
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Telephone | 214-772-3241
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Fax | 214-594-9486
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Authorized Official
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Title or Position | OWNER
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Name | DUNG NGUYEN
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Credential |
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Telephone | 214-772-3241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State | TX
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