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General NPI Number Information
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NPI Number | 1598763435
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Entity Type | Organization
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Legal Business Name | GADDY ENTERPRISES, INC
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 300 HURST ST
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City | CENTER
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State | TX
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Zip | 75935-4211
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Country | US
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Telephone | 936-590-4464
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Fax | 936-590-4468
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Provider Business Mailing Address
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Address Line | PO BOX 1035
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City | CENTER
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State | TX
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Zip | 75935-1035
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Country | US
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Telephone | 936-590-4464
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Fax | 936-590-4468
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Authorized Official
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Title or Position | PRESIDENT/DIRECTOR
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Name | MS. LILA M GADDY
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Credential |
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Telephone | 936-590-4464
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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 | 0046661
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License Number State | TX
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