Provider Demographics
NPI:1699710210
Name:DTS MEDICAL SUPPLY CORP
Entity type:Organization
Organization Name:DTS MEDICAL SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KELLY-TUORILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-382-5454
Mailing Address - Street 1:121 N TEEL DR
Mailing Address - Street 2:
Mailing Address - City:DEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:78016-2932
Mailing Address - Country:US
Mailing Address - Phone:830-663-4766
Mailing Address - Fax:830-663-3368
Practice Address - Street 1:121 N TEEL DR
Practice Address - Street 2:
Practice Address - City:DEVINE
Practice Address - State:TX
Practice Address - Zip Code:78016-2932
Practice Address - Country:US
Practice Address - Phone:830-663-4766
Practice Address - Fax:830-663-3368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0078590332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5367840002Medicare NSC