Provider Demographics
NPI:1366623027
Name:TESSY MEDICAL SUPPLY & EQUIPMENTS
Entity Type:Organization
Organization Name:TESSY MEDICAL SUPPLY & EQUIPMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:UNANMA
Authorized Official - Last Name:OGBOLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-221-5191
Mailing Address - Street 1:9550 FOREST LN
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5905
Mailing Address - Country:US
Mailing Address - Phone:214-221-5191
Mailing Address - Fax:214-221-5194
Practice Address - Street 1:9550 FOREST LN
Practice Address - Street 2:SUITE 107
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5905
Practice Address - Country:US
Practice Address - Phone:214-221-5191
Practice Address - Fax:214-221-5194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6109180001Medicare NSC