MEDICARE: ECLAT, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1518102706
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ECLAT, INC

Provider Business Mailing Address
First Line	:	PO BOX 1495
Second Line	:
City	:	MONT BELVIEU
State	:	TX
Zip	:	77580-1495
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5911 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77057-7603
Country	:	US
Telephone Number	:	713-582-4156
Fax Number	:

Authorized Official
Title or Position	:	MANAGER/FITNESS CONSULTANT
Name	:	SCOTT TOPPELL
Credential	:
Telephone Number	:	713-582-4156

Provider Enumeration Date	:	12/02/2008
Last Update Date	:	12/02/2008

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