Provider Demographics
NPI:1376568055
Name:KOMEDICAL INC
Entity Type:Organization
Organization Name:KOMEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATE
Authorized Official - Middle Name:C
Authorized Official - Last Name:NKUKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-595-0909
Mailing Address - Street 1:301 S 9TH ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3448
Mailing Address - Country:US
Mailing Address - Phone:832-595-0909
Mailing Address - Fax:832-595-0919
Practice Address - Street 1:301 S 9TH ST
Practice Address - Street 2:SUITE 108
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3448
Practice Address - Country:US
Practice Address - Phone:832-595-0909
Practice Address - Fax:832-595-0919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0090005332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0090005OtherDEVICE DISTRIBUTOR
TX1898967Medicaid
TX5872980001Medicare NSC