MEDICARE: MISSION MEDICAL SUPPLY

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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1225319510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSION MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	10515 BELLAIRE BLVD
Second Line	:	SUITE M
City	:	HOUSTON
State	:	TX
Zip	:	77072-5234
Country	:	US
Telephone Number	:	281-933-3902
Fax Number	:	281-933-3949

Provider Business Practice Location Address
First Line	:	10515 BELLAIRE BLVD
Second Line	:	SUITE M
City	:	HOUSTON
State	:	TX
Zip	:	77072-5234
Country	:	US
Telephone Number	:	281-933-3902
Fax Number	:	281-933-3949

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MIMI DO
Credential	:
Telephone Number	:	281-933-3902

Provider Enumeration Date	:	08/31/2011
Last Update Date	:	03/18/2013

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Directions to “MISSION MEDICAL SUPPLY ” Practice Location

Language	Start Address	Practice Location

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