Provider Demographics
NPI:1306872890
Name:M'S MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:M'S MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:KISIJARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-599-3633
Mailing Address - Street 1:2430 FRY RD STE 106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-5831
Mailing Address - Country:US
Mailing Address - Phone:281-599-3633
Mailing Address - Fax:281-599-0524
Practice Address - Street 1:2430 FRY RD STE 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5831
Practice Address - Country:US
Practice Address - Phone:281-599-3633
Practice Address - Fax:281-599-0524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BP3500X
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176406001Medicaid
TX176406003Medicaid
TX5287880001OtherMEDICARE