Provider Demographics
NPI:1194771436
Name:TANGLEWOOD MEDICAL SUPPLIES, INC.
Entity type:Organization
Organization Name:TANGLEWOOD MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:CASE
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:254-968-6999
Mailing Address - Street 1:2445 SENATOR ROBERT J GLASGOW LOOP STE B
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-1705
Mailing Address - Country:US
Mailing Address - Phone:254-968-6999
Mailing Address - Fax:254-968-6167
Practice Address - Street 1:2445 SENATOR ROBERT J GLASGOW LOOP STE B
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-1705
Practice Address - Country:US
Practice Address - Phone:254-968-6999
Practice Address - Fax:254-968-6167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0955600001Medicare NSC