Provider Demographics
NPI:1699952283
Name:TEXAS MEDICAL SUPPLY
Entity type:Organization
Organization Name:TEXAS MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SYLVESTER
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:AFIA
Authorized Official - Suffix:SR
Authorized Official - Credentials:DME
Authorized Official - Phone:972-681-5661
Mailing Address - Street 1:PO BOX 1356
Mailing Address - Street 2:LAKE DALLAS
Mailing Address - City:LAKE DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75065-1356
Mailing Address - Country:US
Mailing Address - Phone:972-681-5661
Mailing Address - Fax:972-681-1103
Practice Address - Street 1:4933 MARKETPLACE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-5013
Practice Address - Country:US
Practice Address - Phone:972-681-5661
Practice Address - Fax:972-681-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0070370332B00000X
TXTX12480332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4996430001Medicare NSC