Provider Demographics
NPI:1134115041
Name:BREATHING DISORDERS SERVICES
Entity Type:Organization
Organization Name:BREATHING DISORDERS SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:TRUITT
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:405-635-0004
Mailing Address - Street 1:PO BOX 269035
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-9035
Mailing Address - Country:US
Mailing Address - Phone:405-635-0004
Mailing Address - Fax:
Practice Address - Street 1:3500 OAKMONT BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6009
Practice Address - Country:US
Practice Address - Phone:405-635-0004
Practice Address - Fax:405-635-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0979990008Medicare NSC