Provider Demographics
NPI:1134182959
Name:DALLAS MEDICAL SUPPLIES LTD CO
Entity type:Organization
Organization Name:DALLAS MEDICAL SUPPLIES LTD CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BETHEL
Authorized Official - Middle Name:PAPPACHEN
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-226-2212
Mailing Address - Street 1:346 OAKS TRAIL
Mailing Address - Street 2:SUITE 109
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043
Mailing Address - Country:US
Mailing Address - Phone:972-226-2212
Mailing Address - Fax:972-226-2212
Practice Address - Street 1:346 OAKS TRAIL
Practice Address - Street 2:SUITE 109
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043
Practice Address - Country:US
Practice Address - Phone:972-226-2212
Practice Address - Fax:972-226-2212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0087089332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5581620001Medicare ID - Type Unspecified