Provider Demographics
NPI:1790873289
Name:M OLIVEIRA DME INC.
Entity Type:Organization
Organization Name:M OLIVEIRA DME INC.
Other - Org Name:MEDIQUIP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-618-2040
Mailing Address - Street 1:105 E INTERSTATE 2
Mailing Address - Street 2:SUITE D
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-6562
Mailing Address - Country:US
Mailing Address - Phone:956-781-1713
Mailing Address - Fax:956-223-2651
Practice Address - Street 1:105 E INTERSTATE 2
Practice Address - Street 2:SUITE D
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-1720
Practice Address - Country:US
Practice Address - Phone:956-781-1713
Practice Address - Fax:956-223-2651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0012749332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX179370502 - DM2Medicaid
TX179370501 - CCPMedicaid
TX179370502 - DM2Medicaid