MEDICARE: SERENITY 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	332B00000X	Durable Medical Equipment & Medical Supplies	0089335	TX

General Provider Information

NPI Number	:	1417978354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SERENITY MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	9343 NORTH LOOP E
Second Line	:	640
City	:	HOUSTON
State	:	TX
Zip	:	77029-1251
Country	:	US
Telephone Number	:	713-674-1884
Fax Number	:

Provider Business Practice Location Address
First Line	:	9343 NORTH LOOP E
Second Line	:	640
City	:	HOUSTON
State	:	TX
Zip	:	77029-1251
Country	:	US
Telephone Number	:	713-674-1884
Fax Number	:	713-675-1510

Authorized Official
Title or Position	:	OWNER
Name	:	CHIACAUSLYN C DEBLAW
Credential	:
Telephone Number	:	713-674-1884

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	08/22/2020

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Directions to “SERENITY MEDICAL SUPPLY ” Practice Location

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