Provider Demographics
NPI:1407102874
Name:INDECON, INC.
Entity Type:Organization
Organization Name:INDECON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-385-7250
Mailing Address - Street 1:333 MELROSE DRIVE
Mailing Address - Street 2:#24-A
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080
Mailing Address - Country:US
Mailing Address - Phone:214-385-7250
Mailing Address - Fax:214-594-0123
Practice Address - Street 1:333 MELROSE DRIVE
Practice Address - Street 2:#24-A
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080
Practice Address - Country:US
Practice Address - Phone:214-385-7250
Practice Address - Fax:214-594-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies