MEDICARE: NEOTERRA ENTERPRISES, L.L.C.

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)	0075647	TX
2	332B00000X	Durable Medical Equipment & Medical Supplies	0075647	TX

General Provider Information

NPI Number	:	1720007214
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEOTERRA ENTERPRISES, L.L.C.

Provider Business Mailing Address
First Line	:	8866 GULF FWY
Second Line	:	SUITE 400
City	:	HOUSTON
State	:	TX
Zip	:	77017-6514
Country	:	US
Telephone Number	:	713-944-0500
Fax Number	:	713-944-0600

Provider Business Practice Location Address
First Line	:	8866 GULF FWY
Second Line	:	SUITE 400
City	:	HOUSTON
State	:	TX
Zip	:	77017-6514
Country	:	US
Telephone Number	:	713-944-0500
Fax Number	:	713-944-0600

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. PANTARATH LAPASUMPANNO
Credential	:
Telephone Number	:	713-944-0500

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	03/06/2008

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Directions to “NEOTERRA ENTERPRISES, L.L.C. ” Practice Location

Language	Start Address	Practice Location

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