Provider Demographics
NPI:1093760308
Name:B-A LLC
Entity type:Organization
Organization Name:B-A LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BOB
Authorized Official - Middle Name:
Authorized Official - Last Name:OCUNAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-854-1380
Mailing Address - Street 1:3833 S STAPLES ST
Mailing Address - Street 2:STE 110 BLDG SOUTH
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5201
Mailing Address - Country:US
Mailing Address - Phone:361-854-1380
Mailing Address - Fax:361-854-1387
Practice Address - Street 1:3833 S STAPLES ST
Practice Address - Street 2:STE 110 BLDG SOUTH
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5201
Practice Address - Country:US
Practice Address - Phone:361-854-1380
Practice Address - Fax:361-854-1387
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5723390001Medicare NSC