MEDICARE: DURABLE MEDICAL EQUIPMENT SOLUTION

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	332BC3200X	Customized Equipment (DME)	32016929591	TX

General Provider Information

NPI Number	:	1205034709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURABLE MEDICAL EQUIPMENT SOLUTION

Provider Business Mailing Address
First Line	:	8034 CULEBRA RD
Second Line	:	SUITE 114
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-1882
Country	:	US
Telephone Number	:	210-744-3325
Fax Number	:	210-521-1924

Provider Business Practice Location Address
First Line	:	8034 CULEBRA RD
Second Line	:	SUITE 114
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-1882
Country	:	US
Telephone Number	:	210-744-3325
Fax Number	:	210-521-1924

Authorized Official
Title or Position	:	OWNER
Name	:	ERNEST A GONZALES
Credential	:
Telephone Number	:	210-744-3325

Provider Enumeration Date	:	07/05/2007
Last Update Date	:	09/28/2007

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