Provider Demographics
NPI:1528037538
Name:MEDICAL PLUS SUPPLIES INC
Entity Type:Organization
Organization Name:MEDICAL PLUS SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ESTEBAN
Authorized Official - Middle Name:VICTOR
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-440-6700
Mailing Address - Street 1:PO BOX 84110
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0018
Mailing Address - Country:US
Mailing Address - Phone:800-298-3948
Mailing Address - Fax:186-686-7739
Practice Address - Street 1:4025 W FUQUA ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77045-6303
Practice Address - Country:US
Practice Address - Phone:800-298-3948
Practice Address - Fax:866-867-7395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0033221332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX016097001Medicaid
1639265OtherLOUISIANA MEDICAID
TX087340801OtherCCP
TX087340801OtherCCP