Provider Demographics
NPI:1619991759
Name:B.I.MEDICAL SUPPLY
Entity Type:Organization
Organization Name:B.I.MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BASSEY
Authorized Official - Middle Name:MONDAY
Authorized Official - Last Name:IDIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-785-1984
Mailing Address - Street 1:9950 WESTPARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5188
Mailing Address - Country:US
Mailing Address - Phone:713-785-1984
Mailing Address - Fax:
Practice Address - Street 1:9950 WESTPARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5188
Practice Address - Country:US
Practice Address - Phone:713-785-1984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0086921332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies