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General NPI Number Information
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NPI Number | 1821457946
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Entity Type | Organization
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Legal Business Name | IT3 MEDICAL LLC
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Dates
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Enumeration Date | 02/17/2016
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Last Update Date | 03/22/2017
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Provider Practice Location Address
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Address Line | 610 PRESIDENTIAL DRIVE SUITE 110
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City | RICHARDSON
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State | TX
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Zip | 75081-2956
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Country | US
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Telephone | 469-453-0300
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Fax | 469-814-8321
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Provider Business Mailing Address
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Address Line | 190 E STACY RD SUITE 306-298
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City | ALLEN
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State | TX
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Zip | 75002-8734
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Country | US
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Telephone | 469-453-0300
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Fax | 469-814-8321
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Authorized Official
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Title or Position | BILLING DIRECTOR
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Name | BELINDA ACOSTA
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Credential |
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Telephone | 469-453-0300
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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 | 1001684
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License Number State | TX
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