Provider Demographics
NPI:1114097490
Name:ALL STAR MEDICAL EQUIPMENT & SUPPLIES INC
Entity Type:Organization
Organization Name:ALL STAR MEDICAL EQUIPMENT & SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ALFONSO
Authorized Official - Middle Name:
Authorized Official - Last Name:CUENTAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-521-2100
Mailing Address - Street 1:84 NE LOOP 410 STE 281
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-8406
Mailing Address - Country:US
Mailing Address - Phone:210-521-2100
Mailing Address - Fax:210-521-2110
Practice Address - Street 1:84 NE LOOP 410 STE 281
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-8406
Practice Address - Country:US
Practice Address - Phone:210-521-2100
Practice Address - Fax:210-521-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0085457332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179636901Medicaid
TX179636902Medicaid
TX179636901Medicaid