Provider Demographics
NPI:1508802448
Name:SMILE MEDICAL EQUIPMENT & SUPPLIES
Entity Type:Organization
Organization Name:SMILE MEDICAL EQUIPMENT & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OVANDO
Authorized Official - Middle Name:ANDRES
Authorized Official - Last Name:BARRERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-844-2893
Mailing Address - Street 1:6547 FM 1430
Mailing Address - Street 2:APT. 28
Mailing Address - City:RIO GRANDE
Mailing Address - State:TX
Mailing Address - Zip Code:78582-9336
Mailing Address - Country:US
Mailing Address - Phone:956-849-9049
Mailing Address - Fax:956-849-9049
Practice Address - Street 1:5088B W HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584-6602
Practice Address - Country:US
Practice Address - Phone:956-849-9049
Practice Address - Fax:956-849-9049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0089440332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment