Provider Demographics
NPI:1205355476
Name:CSE PROFESSIONAL SERVICES LLC
Entity type:Organization
Organization Name:CSE PROFESSIONAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:COLE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SPRADLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-757-7636
Mailing Address - Street 1:100 PLAZA DR STE 300
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-3983
Mailing Address - Country:US
Mailing Address - Phone:972-757-7636
Mailing Address - Fax:
Practice Address - Street 1:100 PLAZA DR
Practice Address - Street 2:SUITE 300
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154
Practice Address - Country:US
Practice Address - Phone:972-757-7636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1002095OtherTEXAS MEDICAL DEVICE LICENSE