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General NPI Number Information
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NPI Number | 1659558682
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Entity Type | Organization
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Legal Business Name | MY DME
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Dates
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Enumeration Date | 01/22/2008
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 1544 W. DOVE
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City | MCALLEN
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State | TX
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Zip | 78504
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Country | US
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Telephone | 956-664-0737
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Fax | 956-682-0904
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Provider Business Mailing Address
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Address Line | 1544 W DOVE AVE
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City | MCALLEN
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State | TX
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Zip | 78504-3439
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Country | US
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Telephone | 956-664-0737
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Fax | 956-682-0904
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHRISTOPHER TAGLE
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Credential |
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Telephone | 956-664-0737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0100786
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License Number State | TX
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