Provider Demographics
NPI:1629078175
Name:PERSONAL LIVING SOLUTIONS LP
Entity Type:Organization
Organization Name:PERSONAL LIVING SOLUTIONS LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIREYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-506-8855
Mailing Address - Street 1:100 E WHITESTONE BLVD
Mailing Address - Street 2:#318
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-6902
Mailing Address - Country:US
Mailing Address - Phone:512-506-8855
Mailing Address - Fax:512-506-8860
Practice Address - Street 1:700 S BELL BLVD
Practice Address - Street 2:#F3
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3804
Practice Address - Country:US
Practice Address - Phone:512-506-8855
Practice Address - Fax:512-506-8860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX148405701332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148405701Medicaid
TX0013003OtherGERMICIDAL & BEDDING
TX4059980001OtherMEDICARE PROVIDER NUMBER