Provider Demographics
NPI:1528087707
Name:MEDMART, INC
Entity type:Organization
Organization Name:MEDMART, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-568-3388
Mailing Address - Street 1:9460 W SAM HOUSTON PKWY S
Mailing Address - Street 2:SUITE 802
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-1850
Mailing Address - Country:US
Mailing Address - Phone:281-568-3388
Mailing Address - Fax:281-586-9607
Practice Address - Street 1:9460 W SAM HOUSTON PKWY S
Practice Address - Street 2:SUITE 802
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-1850
Practice Address - Country:US
Practice Address - Phone:281-568-3388
Practice Address - Fax:281-586-9607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0089114332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies