Provider Demographics
NPI:1609918440
Name:ADVANTAGE DME
Entity Type:Organization
Organization Name:ADVANTAGE DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-655-4504
Mailing Address - Street 1:1209 E JASMINE AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5742
Mailing Address - Country:US
Mailing Address - Phone:956-682-5882
Mailing Address - Fax:956-682-5892
Practice Address - Street 1:1209 E JASMINE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5742
Practice Address - Country:US
Practice Address - Phone:956-682-5882
Practice Address - Fax:956-682-5892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179440601Medicaid
TX179440602Medicaid
TX5554820001Medicare NSC