Provider Demographics
NPI:1871505909
Name:ROSA F LOUIS
Entity Type:Organization
Organization Name:ROSA F LOUIS
Other - Org Name:ROSA F LOUIS HERITAGE DURABLE MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:713-733-0332
Mailing Address - Street 1:8109 CULLEN BLVD
Mailing Address - Street 2:SUITE G
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-2064
Mailing Address - Country:US
Mailing Address - Phone:713-733-0332
Mailing Address - Fax:713-733-2243
Practice Address - Street 1:8109 CULLEN BLVD
Practice Address - Street 2:SUITE G
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-2064
Practice Address - Country:US
Practice Address - Phone:713-733-0332
Practice Address - Fax:713-733-2243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0080984332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5454610001Medicare NSC