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General NPI Number Information
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NPI Number | 1629414933
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Entity Type | Organization
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Legal Business Name | MONDEV MEDICAL SOLUTIONS LLC, DBA SPECIALIZED MEDICAL SOLUTIONS
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 7254 BLANCO RD STE 208
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City | SAN ANTONIO
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State | TX
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Zip | 78216-4930
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Country | US
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Telephone | 512-787-4902
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Fax |
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Provider Business Mailing Address
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Address Line | 7254 BLANCO RD STE 208
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City | SAN ANTONIO
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State | TX
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Zip | 78216-4930
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Country | US
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Telephone | 210-236-9824
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Fax | 210-257-8474
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Authorized Official
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Title or Position | OWNER
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Name | MR. RUBEN BECERRA JR.
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Credential |
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Telephone | 512-787-4902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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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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