=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891676771
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HIRO DME CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/09/2025
-----------------------------------------------------
Last Update Date | 09/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 561 W MEDICAL CENTER BLVD STE B
-----------------------------------------------------
City | WEBSTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77598-4240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-955-4341
-----------------------------------------------------
Fax | 713-955-4372
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 561 W MEDICAL CENTER BLVD STE B
-----------------------------------------------------
City | WEBSTER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77598-4240
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-955-4341
-----------------------------------------------------
Fax | 713-955-4372
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | THEODORE JAMES DICKERSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-955-4341
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------