MEDICARE: A&E MEDICAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies		TX

General Provider Information

NPI Number	:	1053440966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A&E MEDICAL

Provider Business Mailing Address
First Line	:	2123 FM 1960 RD W
Second Line	:	#273
City	:	HOUSTON
State	:	TX
Zip	:	77090-3103
Country	:	US
Telephone Number	:	713-530-2312
Fax Number	:

Provider Business Practice Location Address
First Line	:	2123 FM 1960 RD W
Second Line	:	#273
City	:	HOUSTON
State	:	TX
Zip	:	77090-3103
Country	:	US
Telephone Number	:	713-530-2312
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CRAIG A THIRY
Credential	:	D.O.
Telephone Number	:	713-530-2312

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	06/16/2008

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Directions to “A&E MEDICAL ” Practice Location

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