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General NPI Number Information
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NPI Number | 1932124849
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Entity Type | Organization
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Legal Business Name | MI MEDEX INC.
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 12/02/2014
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Provider Practice Location Address
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Address Line | 4800 W EXPRESSWAY 83
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City | MCALLEN
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State | TX
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Zip | 78501-3015
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Country | US
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Telephone | 956-682-2512
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Fax | 956-682-2514
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Provider Business Mailing Address
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Address Line | 4800 W EXPRESSWAY 83
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City | MCALLEN
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State | TX
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Zip | 78501-3015
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Country | US
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Telephone | 956-682-2512
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Fax | 956-682-2514
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ERISTEO JOSE MONTANO
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Credential |
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Telephone | 956-682-2512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 010327
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License Number State | TX
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