MEDICARE: SKILLED MOBILITY, LLC

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)

General Provider Information

NPI Number	:	1306313283
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKILLED MOBILITY, LLC

Provider Business Mailing Address
First Line	:	135 OYSTER CREEK DR STE H
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-4118
Country	:	US
Telephone Number	:	832-914-0991
Fax Number	:

Provider Business Practice Location Address
First Line	:	491B THIS WAY ST
Second Line	:
City	:	LAKE JACKSON
State	:	TX
Zip	:	77566-5144
Country	:	US
Telephone Number	:	832-914-0991
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ATP
Name	:	CODY L BLANCHARD
Credential	:
Telephone Number	:	512-846-3155

Provider Enumeration Date	:	10/29/2018
Last Update Date	:	08/08/2025

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Directions to “SKILLED MOBILITY, LLC ” Practice Location

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