Provider Demographics
NPI:1063503571
Name:DALLAS DME,LLC
Entity Type:Organization
Organization Name:DALLAS DME,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-260-8014
Mailing Address - Street 1:4432 MALCOLM X BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215-4349
Mailing Address - Country:US
Mailing Address - Phone:214-928-9180
Mailing Address - Fax:214-928-9982
Practice Address - Street 1:4432 MALCOLM X BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-4349
Practice Address - Country:US
Practice Address - Phone:214-928-9180
Practice Address - Fax:214-928-9982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies