Provider Demographics
NPI:1760593438
Name:O2 RESPIRATORY MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:O2 RESPIRATORY MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-695-4194
Mailing Address - Street 1:500 N KIMBALL AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6683
Mailing Address - Country:US
Mailing Address - Phone:817-695-4194
Mailing Address - Fax:817-652-9394
Practice Address - Street 1:500 N KIMBALL AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6682
Practice Address - Country:US
Practice Address - Phone:817-695-4194
Practice Address - Fax:817-652-9394
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:O2 RESPIRATORY MEDICAL EQUIPMENT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-31
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0077956332B00000X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1221190001Medicare NSC