Provider Demographics
NPI:1932124849
Name:MI MEDEX INC.
Entity Type:Organization
Organization Name:MI MEDEX INC.
Other - Org Name:MEDEX HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERISTEO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:MONTANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-682-2512
Mailing Address - Street 1:4800 W EXPRESSWAY 83
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-3015
Mailing Address - Country:US
Mailing Address - Phone:956-682-2512
Mailing Address - Fax:956-682-2514
Practice Address - Street 1:4800 W EXPRESSWAY 83
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-3015
Practice Address - Country:US
Practice Address - Phone:956-682-2512
Practice Address - Fax:956-682-2514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010327251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX743108Medicare PIN