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General NPI Number Information
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NPI Number | 1710036660
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Entity Type | Organization
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Legal Business Name | M.D. WAREHOUSE, INC.
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4899 MONTROSE BLVD APT 1903
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City | HOUSTON
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State | TX
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Zip | 77006-6172
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Country | US
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Telephone | 281-507-2156
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Fax | 512-899-2910
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Provider Business Mailing Address
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Address Line | PO BOX 161535
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City | AUSTIN
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State | TX
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Zip | 78716-1535
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Country | US
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Telephone | 281-507-2156
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Fax | 512-899-2910
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | KELSEY GLYNN SHULTS
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Credential | B.A.
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Telephone | 281-507-2156
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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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