Provider Demographics
NPI:1093770935
Name:LAWRENCE S ELLIOTT DBA MEDQUIP
Entity Type:Organization
Organization Name:LAWRENCE S ELLIOTT DBA MEDQUIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-467-3574
Mailing Address - Street 1:3510 OAK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018
Mailing Address - Country:US
Mailing Address - Phone:832-467-3574
Mailing Address - Fax:281-477-0203
Practice Address - Street 1:3510 OAK FOREST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018
Practice Address - Country:US
Practice Address - Phone:832-467-3574
Practice Address - Fax:281-477-0203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0046063332B00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX017272801Medicaid
TX83503OtherDME EVERCARE STAR PLUS
TX17089143OtherEVERCARE COMMUNITY HMO
TX17089143OtherEVERCARE COMMUNITY HMO