Provider Demographics
NPI:1699727842
Name:MEDWHEELS
Entity type:Organization
Organization Name:MEDWHEELS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-533-9457
Mailing Address - Street 1:1322 E HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-2035
Mailing Address - Country:US
Mailing Address - Phone:210-533-9457
Mailing Address - Fax:210-533-9455
Practice Address - Street 1:1322 E HOUSTON ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2035
Practice Address - Country:US
Practice Address - Phone:210-533-9457
Practice Address - Fax:210-533-9455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX17885601Medicaid
TX5605500001Medicare NSC