MEDICARE: THERAPY SUPPLY HOUSE, INC

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
2	332B00000X	Durable Medical Equipment & Medical Supplies	0039563	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	530432	OTHER	TX	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	10020320	OTHER	TX	AMERIGROUP
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215901137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY SUPPLY HOUSE, INC

Provider Business Mailing Address
First Line	:	8572 KATY FWY STE 109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1821
Country	:	US
Telephone Number	:	713-669-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	8572 KATY FWY STE 109
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77024-1821
Country	:	US
Telephone Number	:	713-669-0500
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. OVO W NWABUDIKE
Credential	:	R.N
Telephone Number	:	713-669-0500

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	03/02/2023

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Directions to “THERAPY SUPPLY HOUSE, INC ” Practice Location

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