Provider Demographics
NPI:1659782712
Name:PRAN MEDICAL LLC
Entity Type:Organization
Organization Name:PRAN MEDICAL LLC
Other - Org Name:PRIMO MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIJAYALAXMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KATEPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-519-5311
Mailing Address - Street 1:7515 GRISSOM RD
Mailing Address - Street 2:107
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4746
Mailing Address - Country:US
Mailing Address - Phone:210-519-5311
Mailing Address - Fax:210-399-3561
Practice Address - Street 1:7515 GRISSOM RD
Practice Address - Street 2:107
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4746
Practice Address - Country:US
Practice Address - Phone:210-519-5311
Practice Address - Fax:210-399-3561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition