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General NPI Number Information
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NPI Number | 1912527755
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Entity Type | Organization
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Legal Business Name | DIESEL MEDICAL EQUIPMENT LLC
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 2351 W NORTHWEST HWY STE 3135
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City | DALLAS
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State | TX
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Zip | 75220-4433
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Country | US
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Telephone | 469-577-1613
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Fax | 214-259-3709
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Provider Business Mailing Address
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Address Line | 2351 W NORTHWEST HWY STE 3135
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City | DALLAS
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State | TX
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Zip | 75220-4433
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Country | US
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Telephone | 469-577-1613
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Fax | 214-259-3709
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Authorized Official
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Title or Position | OWNER
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Name | TYLER NORTHCUTT
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Credential |
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Telephone | 580-461-0983
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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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