Provider Demographics
NPI:1225388358
Name:DVO SPORTZ INC
Entity Type:Organization
Organization Name:DVO SPORTZ INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:Y
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-704-8401
Mailing Address - Street 1:2708 NORTHVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4722
Mailing Address - Country:US
Mailing Address - Phone:972-704-8401
Mailing Address - Fax:
Practice Address - Street 1:2708 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4722
Practice Address - Country:US
Practice Address - Phone:972-704-8401
Practice Address - Fax:214-856-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies