Provider Demographics
NPI:1326068164
Name:PECO ENTERPRISES INC
Entity Type:Organization
Organization Name:PECO ENTERPRISES INC
Other - Org Name:MEDICOS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-494-3334
Mailing Address - Street 1:1910 SILVER ST
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6645
Mailing Address - Country:US
Mailing Address - Phone:972-494-3334
Mailing Address - Fax:972-487-9663
Practice Address - Street 1:1910 SILVER ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6645
Practice Address - Country:US
Practice Address - Phone:972-494-3334
Practice Address - Fax:972-487-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXZ05089959Medicaid
TXZ05089959Medicaid