Provider Demographics
NPI:1609485697
Name:HOUSTON CARE MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:HOUSTON CARE MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAWANNA
Authorized Official - Middle Name:LAQUITHA
Authorized Official - Last Name:MYLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-243-0948
Mailing Address - Street 1:440 BENMAR DR STE 1022E
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3271
Mailing Address - Country:US
Mailing Address - Phone:346-243-0948
Mailing Address - Fax:
Practice Address - Street 1:440 BENMAR DR STE 1022E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3271
Practice Address - Country:US
Practice Address - Phone:346-243-0948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies