MEDICARE: MEDICAL TECHNOLOGIES, 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	332BX2000X	Oxygen Equipment & Supplies (DME)	1000463	TX

General Provider Information

NPI Number	:	1427359694
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL TECHNOLOGIES, INC.

Provider Business Mailing Address
First Line	:	401 W COLLEGE ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-1527
Country	:	US
Telephone Number	:	337-491-1100
Fax Number	:	337-491-1122

Provider Business Practice Location Address
First Line	:	7824 JONES MALTSBERGER RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-6919
Country	:	US
Telephone Number	:	210-826-0481
Fax Number	:	210-826-0634

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOHN DAVID MONLEZUN
Credential	:
Telephone Number	:	337-491-1100

Provider Enumeration Date	:	11/04/2010
Last Update Date	:	05/11/2012

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