Provider Demographics
NPI:1033487475
Name:POLYSOM SERVICES
Entity Type:Organization
Organization Name:POLYSOM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ENNIS
Authorized Official - Middle Name:DWIGHT
Authorized Official - Last Name:OSTEEN
Authorized Official - Suffix:II
Authorized Official - Credentials:RPSGT
Authorized Official - Phone:832-303-1211
Mailing Address - Street 1:3422 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77388-9330
Mailing Address - Country:US
Mailing Address - Phone:832-527-6289
Mailing Address - Fax:
Practice Address - Street 1:3422 MEADOWLARK LN
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388-9330
Practice Address - Country:US
Practice Address - Phone:832-527-6289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies