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General NPI Number Information
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NPI Number | 1982649844
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Entity Type | Organization
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Legal Business Name | TEXAS DURABLE MEDICAL CO
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 03/21/2011
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Provider Practice Location Address
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Address Line | 8449 W BELLFORT ST #110
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City | HOUSTON
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State | TX
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Zip | 77071-2245
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Country | US
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Telephone | 713-771-8362
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Fax | 713-771-8364
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Provider Business Mailing Address
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Address Line | 8449 W BELLFORT ST #110
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City | HOUSTON
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State | TX
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Zip | 77071-2245
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Country | US
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Telephone | 713-771-8362
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Fax | 713-771-8364
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Authorized Official
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Title or Position | OWNER
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Name | MS. ANDREA MICHELLE TELLISON
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Credential |
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Telephone | 713-771-8362
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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 | 006519196
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License Number State | TX
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