Provider Demographics
NPI:1821598897
Name:MEDI-LAB MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:MEDI-LAB MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-360-7889
Mailing Address - Street 1:4301 N 22ND ST STE A
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0035
Mailing Address - Country:US
Mailing Address - Phone:956-800-5008
Mailing Address - Fax:956-800-5311
Practice Address - Street 1:4301 N 22ND ST STE A
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-0035
Practice Address - Country:US
Practice Address - Phone:956-800-5008
Practice Address - Fax:956-800-5311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001502332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1104334192OtherNPI