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General NPI Number Information
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NPI Number | 1871313163
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Entity Type | Organization
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Legal Business Name | TEXAN ROOTS LLC
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Dates
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Enumeration Date | 10/12/2024
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 3513 LILAC DRIVE
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City | AUBREY
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State | TX
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Zip | 76227
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Country | US
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Telephone | 972-493-0643
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Fax |
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Provider Business Mailing Address
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Address Line | 6010 W SPRING CREEK PKWY # 1011
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City | PLANO
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State | TX
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Zip | 75024-3569
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Country | US
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Telephone | 972-493-0643
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MR. ZAIN ALI
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Credential |
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Telephone | 972-493-0643
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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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