Provider Demographics
NPI:1639357320
Name:I. R. A. - MEDICAL SUPPLY
Entity Type:Organization
Organization Name:I. R. A. - MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:DYNELL
Authorized Official - Last Name:MCLEAN-AUTREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-641-0519
Mailing Address - Street 1:7447 HARWIN DR STE 243G
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2051
Mailing Address - Country:US
Mailing Address - Phone:832-641-0519
Mailing Address - Fax:206-350-6639
Practice Address - Street 1:7447 HARWIN DR STE 243G
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2051
Practice Address - Country:US
Practice Address - Phone:832-641-0519
Practice Address - Fax:206-350-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies