Provider Demographics
NPI:1912195066
Name:SPACE CENTER RESPIRATORY EQUIPMENT LLP
Entity Type:Organization
Organization Name:SPACE CENTER RESPIRATORY EQUIPMENT LLP
Other - Org Name:NASA MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-488-4463
Mailing Address - Street 1:17300 SATURN LN
Mailing Address - Street 2:SUITE 108
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2261
Mailing Address - Country:US
Mailing Address - Phone:281-488-4463
Mailing Address - Fax:281-488-4465
Practice Address - Street 1:17300 SATURN LN
Practice Address - Street 2:SUITE 108
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2261
Practice Address - Country:US
Practice Address - Phone:281-488-4463
Practice Address - Fax:281-488-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0053236332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies