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General NPI Number Information
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NPI Number | 1790300457
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Entity Type | Organization
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Legal Business Name | UNITED WELLNESS DME LLC
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 2611 N TEXAS BLVD STE 3
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City | WESLACO
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State | TX
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Zip | 78599-4062
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Country | US
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Telephone | 956-520-7577
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Fax | 956-520-7575
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Provider Business Mailing Address
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Address Line | PO BOX 1777
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City | WESLACO
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State | TX
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Zip | 78599-1777
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BRENDA BARBOZA
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Credential | MOL, BS HCM
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Telephone | 956-402-8865
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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 |
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License Number State |
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