Provider Demographics
NPI:1063661379
Name:DURABLE PVC MEDICAL PRODUCTS LLC
Entity Type:Organization
Organization Name:DURABLE PVC MEDICAL PRODUCTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRISELDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-585-8202
Mailing Address - Street 1:1820 E GRIFFIN PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-3109
Mailing Address - Country:US
Mailing Address - Phone:956-585-8202
Mailing Address - Fax:956-585-8203
Practice Address - Street 1:1820 E GRIFFIN PKWY STE B
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3109
Practice Address - Country:US
Practice Address - Phone:956-585-8202
Practice Address - Fax:956-585-8203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0105180332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment