MEDICARE: HEALTHTRONIX LYMPHEDEMA MANAGEMENT, 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	0067482	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0050GZ	OTHER	TX	BCBS OF TEXAS - CLINIC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	103945100	OTHER	TX	FIRSTCARE
5	516256	OTHER	TX	BCBS OF TEXAS - DME

General Provider Information

NPI Number	:	1902808116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHTRONIX LYMPHEDEMA MANAGEMENT, INC.

Provider Business Mailing Address
First Line	:	PO BOX 861840
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75086-1840
Country	:	US
Telephone Number	:	972-231-6511
Fax Number	:	972-437-5513

Provider Business Practice Location Address
First Line	:	850 E ARAPAHO RD
Second Line	:	STE 210
City	:	RICHARDSON
State	:	TX
Zip	:	75081-2256
Country	:	US
Telephone Number	:	972-231-6511
Fax Number	:	972-437-5513

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. CHERI L HOSKINS
Credential	:
Telephone Number	:	972-231-6511

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	06/01/2009

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