Provider Demographics
NPI:1477524288
Name:STREETS D.M.E. L.L.C.
Entity Type:Organization
Organization Name:STREETS D.M.E. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BARCELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-338-0870
Mailing Address - Street 1:1320 HIGHWAY 3 S
Mailing Address - Street 2:SUITE C 3
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-5458
Mailing Address - Country:US
Mailing Address - Phone:281-338-0870
Mailing Address - Fax:281-557-4608
Practice Address - Street 1:1320 HIGHWAY 3 S
Practice Address - Street 2:SUITE C 3
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-5458
Practice Address - Country:US
Practice Address - Phone:281-338-0870
Practice Address - Fax:281-557-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0086149332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4793720001Medicare NSC