Provider Demographics
NPI:1376559104
Name:CENTRAL TEXAS DME INC.
Entity Type:Organization
Organization Name:CENTRAL TEXAS DME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-751-0699
Mailing Address - Street 1:600 LAKE AIR DR STE 8B
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-5888
Mailing Address - Country:US
Mailing Address - Phone:254-751-0699
Mailing Address - Fax:
Practice Address - Street 1:600 LAKE AIR DR STE 8B
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-5888
Practice Address - Country:US
Practice Address - Phone:254-751-0699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0082357332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0082357OtherMEDICAL DEVICE DISTRIBUTO
TX5537040001Medicare NSC