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General NPI Number Information
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NPI Number | 1639357320
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Entity Type | Organization
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Legal Business Name | I. R. A. - MEDICAL SUPPLY
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Dates
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Enumeration Date | 02/05/2008
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 7447 HARWIN DR STE 243G
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City | HOUSTON
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State | TX
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Zip | 77036-2051
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Country | US
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Telephone | 832-641-0519
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Fax | 206-350-6639
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Provider Business Mailing Address
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Address Line | 7447 HARWIN DR STE 243G
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City | HOUSTON
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State | TX
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Zip | 77036-2051
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Country | US
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Telephone | 832-641-0519
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Fax | 206-350-6639
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Authorized Official
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Title or Position | OWNER
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Name | MRS. LINDA DYNELL MCLEAN-AUTREY
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Credential |
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Telephone | 832-641-0519
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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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