Provider Demographics
NPI:1609014208
Name:KIDS DME, INC.
Entity Type:Organization
Organization Name:KIDS DME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN AND ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVIAR
Authorized Official - Suffix:II
Authorized Official - Credentials:RN
Authorized Official - Phone:956-554-4900
Mailing Address - Street 1:2102 W TEEGE AVE STE G
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-4667
Mailing Address - Country:US
Mailing Address - Phone:956-554-4900
Mailing Address - Fax:956-554-3525
Practice Address - Street 1:2102 W TEEGE AVE STE G
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-4667
Practice Address - Country:US
Practice Address - Phone:956-554-4900
Practice Address - Fax:956-554-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-04
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6350190001Medicare NSC