Provider Demographics
NPI:1790845535
Name:ARAY MEDICAL EQUIP REPAIR, INC.
Entity Type:Organization
Organization Name:ARAY MEDICAL EQUIP REPAIR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:QUAAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-472-8585
Mailing Address - Street 1:4205 SPENCER HWY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1221
Mailing Address - Country:US
Mailing Address - Phone:713-472-8585
Mailing Address - Fax:713-944-0028
Practice Address - Street 1:4205 SPENCER HWY
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1221
Practice Address - Country:US
Practice Address - Phone:713-472-8585
Practice Address - Fax:713-944-0028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0041638332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1186910001Medicare ID - Type UnspecifiedPROVIDER #