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General NPI Number Information
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NPI Number | 1841428067
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Entity Type | Organization
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Legal Business Name | DEL - GAR, LLC
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | 1307 E AIRLINE RD
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City | VICTORIA
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State | TX
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Zip | 77901-4152
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Country | US
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Telephone | 361-578-5944
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Fax | 361-578-5945
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Provider Business Mailing Address
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Address Line | 1307 E AIRLINE RD
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City | VICTORIA
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State | TX
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Zip | 77901-4152
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Country | US
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Telephone | 361-578-5944
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Fax | 361-578-5945
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Authorized Official
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Title or Position | OWNER
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Name | PATRICIO DE LEON JR.
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Credential |
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Telephone | 361-676-7351
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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 | 1000102
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License Number State | TX
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