Provider Demographics
NPI:1629065107
Name:TG WHEELCHAIR, INC.
Entity Type:Organization
Organization Name:TG WHEELCHAIR, INC.
Other - Org Name:TOM'S WHEELCHAIR REPAIR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-223-7878
Mailing Address - Street 1:118 BROADWAY ST
Mailing Address - Street 2:SUITE 540
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1950
Mailing Address - Country:US
Mailing Address - Phone:210-223-7878
Mailing Address - Fax:210-223-0078
Practice Address - Street 1:118 BROADWAY ST
Practice Address - Street 2:SUITE 540
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1950
Practice Address - Country:US
Practice Address - Phone:210-223-7878
Practice Address - Fax:210-223-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX 0012812332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5759470001Medicare NSC