Provider Demographics
NPI:1033538657
Name:MEDICOR HEALTHCARE, INC.
Entity Type:Organization
Organization Name:MEDICOR HEALTHCARE, INC.
Other - Org Name:MEDICOR HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:9729-263-7100
Mailing Address - Street 1:1731 WALL ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041-4061
Mailing Address - Country:US
Mailing Address - Phone:972-926-7100
Mailing Address - Fax:972-926-1700
Practice Address - Street 1:1731 WALL ST
Practice Address - Street 2:SUITE 204
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041-4061
Practice Address - Country:US
Practice Address - Phone:972-926-7100
Practice Address - Fax:972-926-1700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0081934332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies