Provider Demographics
NPI:1538309554
Name:MIRAE TRADING CO.
Entity Type:Organization
Organization Name:MIRAE TRADING CO.
Other - Org Name:AH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MI
Authorized Official - Middle Name:JA
Authorized Official - Last Name:SON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-417-9269
Mailing Address - Street 1:2527 ROYAL LN STE 140
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75229-3430
Mailing Address - Country:US
Mailing Address - Phone:214-417-9269
Mailing Address - Fax:
Practice Address - Street 1:2527 ROYAL LN STE 140
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-3430
Practice Address - Country:US
Practice Address - Phone:214-417-9269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0109183332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies