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General NPI Number Information
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NPI Number | 1770712150
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Entity Type | Organization
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Legal Business Name | MISSION MEDICAL EQUIPMENT & DIABETIC SUPPLIES
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 900 PLAZA DR SUITE 4-B
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City | MISSION
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State | TX
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Zip | 78572-6045
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Country | US
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Telephone | 956-583-0363
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Fax | 956-583-0397
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Provider Business Mailing Address
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Address Line | 900 PLAZA DR SUITE 4-B
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City | MISSION
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State | TX
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Zip | 78572-6045
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Country | US
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Telephone | 956-583-0363
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Fax | 956-583-0397
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Authorized Official
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Title or Position | OWNER
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Name | OSCAR ROMAN
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Credential |
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Telephone | 956-638-0128
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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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