Provider Demographics
NPI:1922265677
Name:EAST TEXAS MEDICAL EQUIPMENT INC.
Entity Type:Organization
Organization Name:EAST TEXAS MEDICAL EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OBANOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-489-1111
Mailing Address - Street 1:13619 TONNOCHY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-6042
Mailing Address - Country:US
Mailing Address - Phone:281-216-2555
Mailing Address - Fax:281-667-3142
Practice Address - Street 1:420 STATE ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-5135
Practice Address - Country:US
Practice Address - Phone:409-489-1111
Practice Address - Fax:281-667-3142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies