Provider Demographics
NPI:1104829175
Name:ABC DURABLE MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:ABC DURABLE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRES ADMINISTRATA
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:S
Authorized Official - Last Name:VELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-584-2775
Mailing Address - Street 1:919 N SLABAUGH ST
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572
Mailing Address - Country:US
Mailing Address - Phone:956-584-2775
Mailing Address - Fax:956-580-4788
Practice Address - Street 1:919 N SLABAUGH ST
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572
Practice Address - Country:US
Practice Address - Phone:956-584-2775
Practice Address - Fax:956-580-4788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0070727332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180026002Medicaid
TX165432901Medicaid
TX180026002Medicaid