Provider Demographics
NPI:1174859433
Name:AMIGOS MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:AMIGOS MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-630-5757
Mailing Address - Street 1:4129 N 22ND ST
Mailing Address - Street 2:STE 1
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-4146
Mailing Address - Country:US
Mailing Address - Phone:956-630-5757
Mailing Address - Fax:956-630-5758
Practice Address - Street 1:4129 N 22ND ST
Practice Address - Street 2:STE 1
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-4146
Practice Address - Country:US
Practice Address - Phone:956-630-5757
Practice Address - Fax:956-630-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000155332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000155OtherTDSHS