=====================================================
General NPI Number Information
=====================================================
NPI Number | 1952654071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AUTO & HOME MOBILITY SOLUTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2012
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8885 E STATE HIGHWAY 21
-----------------------------------------------------
City | BRYAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77808-8673
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-589-2005
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8885 E STATE HIGHWAY 21
-----------------------------------------------------
City | BRYAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77808-8673
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-589-2005
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. KYLE D SMITH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 979-589-2005
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 19
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------