Provider Demographics
NPI:1679141162
Name:DYNAMIC MEDICAL LLC
Entity Type:Organization
Organization Name:DYNAMIC MEDICAL LLC
Other - Org Name:DYNAMIC MEDICAL SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MARKETING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MINERVA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MENDOZA
Authorized Official - Suffix:
Authorized Official - Credentials:COF, CFO, CMF
Authorized Official - Phone:210-876-1130
Mailing Address - Street 1:13807 RED MAPLE WOOD STE 201B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3707
Mailing Address - Country:US
Mailing Address - Phone:210-876-1130
Mailing Address - Fax:210-455-1202
Practice Address - Street 1:13807 RED MAPLE WOOD STE 201B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3707
Practice Address - Country:US
Practice Address - Phone:210-876-1130
Practice Address - Fax:210-455-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-11
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies