Provider Demographics
NPI:1063593143
Name:DELTA MEDICAL EQUIPMENT & SUPPLY
Entity type:Organization
Organization Name:DELTA MEDICAL EQUIPMENT & SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-262-1900
Mailing Address - Street 1:311 WEST EDINBURG AVE
Mailing Address - Street 2:P.O. BOX 1059
Mailing Address - City:ELSA
Mailing Address - State:TX
Mailing Address - Zip Code:78543-1059
Mailing Address - Country:US
Mailing Address - Phone:956-262-1900
Mailing Address - Fax:956-262-1903
Practice Address - Street 1:311 WEST EDINBURG AVE
Practice Address - Street 2:
Practice Address - City:ELSA
Practice Address - State:TX
Practice Address - Zip Code:78543-1059
Practice Address - Country:US
Practice Address - Phone:956-262-1900
Practice Address - Fax:956-262-1903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0087448332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5590180001Medicare ID - Type Unspecified