Provider Demographics
NPI:1568676740
Name:KATY UNIVERSAL MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:KATY UNIVERSAL MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DHARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-371-3200
Mailing Address - Street 1:5160 FRANZ RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493
Mailing Address - Country:US
Mailing Address - Phone:281-371-3200
Mailing Address - Fax:281-371-3201
Practice Address - Street 1:5160 FRANZ RD
Practice Address - Street 2:SUITE B
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493
Practice Address - Country:US
Practice Address - Phone:281-371-3200
Practice Address - Fax:281-371-3201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KATY UNIVERSAL MEDICAL SUPPLY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-09
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0095417332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6035370001Medicare NSC