Provider Demographics
NPI:1326150566
Name:SOUTH TEX MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:SOUTH TEX MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:G
Authorized Official - Last Name:AZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-687-4469
Mailing Address - Street 1:1516 W DOVE AVE
Mailing Address - Street 2:SUITE I
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3495
Mailing Address - Country:US
Mailing Address - Phone:956-687-4469
Mailing Address - Fax:956-687-4469
Practice Address - Street 1:1516 W DOVE AVE
Practice Address - Street 2:SUITE I
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3495
Practice Address - Country:US
Practice Address - Phone:956-687-4469
Practice Address - Fax:956-687-4469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X332B00000X
TX332BP3500X332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4795520001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER