Provider Demographics
NPI:1275665614
Name:DELTA DME
Entity Type:Organization
Organization Name:DELTA DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOU-KAYYAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-288-3471
Mailing Address - Street 1:2611 N BELTLINE RD
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-9356
Mailing Address - Country:US
Mailing Address - Phone:972-203-0753
Mailing Address - Fax:972-203-8146
Practice Address - Street 1:2611 N BELTLINE RD
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-9356
Practice Address - Country:US
Practice Address - Phone:972-203-0753
Practice Address - Fax:972-203-8146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172711701Medicaid
TX172711702Medicaid
TX172711702Medicaid