MEDICARE: RESPIRA MEDICAL, L.P.

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)	0081452	TX
2	332B00000X	Durable Medical Equipment & Medical Supplies	0081452	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17327	OTHER	TX	PARKLAND HEALTHCARE
2	531843	OTHER	TX	BLUE CROSS BLUE SHIELD
3	7824752	OTHER	TX	COOK CHILDRENS HEALTH PLAN
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	10043946	OTHER	TX	AMERIGROUP
6	147875	OTHER	TX	SUPERIOR HEALTH
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255441796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESPIRA MEDICAL, L.P.

Provider Business Mailing Address
First Line	:	1502 HOUSTON ST # 100
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-5206
Country	:	US
Telephone Number	:	817-695-6900
Fax Number	:	817-695-6901

Provider Business Practice Location Address
First Line	:	1502 HOUSTON ST # 100
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-5206
Country	:	US
Telephone Number	:	817-695-6900
Fax Number	:	817-695-6901

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. BRENDA HORNYAK
Credential	:
Telephone Number	:	817-695-6900

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	07/29/2011

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Directions to “RESPIRA MEDICAL, L.P. ” Practice Location

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