Provider Demographics
NPI:1215901137
Name:THERAPY SUPPLY HOUSE, INC
Entity type:Organization
Organization Name:THERAPY SUPPLY HOUSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:OVO
Authorized Official - Middle Name:W
Authorized Official - Last Name:NWABUDIKE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-669-0500
Mailing Address - Street 1:8572 KATY FWY STE 109
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-1821
Mailing Address - Country:US
Mailing Address - Phone:713-669-0500
Mailing Address - Fax:
Practice Address - Street 1:8572 KATY FWY STE 109
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1821
Practice Address - Country:US
Practice Address - Phone:713-669-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX0039563332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011817601Medicaid
TX530432OtherBLUE CROSS
TX010295601Medicaid
TX010295603Medicaid
TX10020320OtherAMERIGROUP
TX010295602Medicaid
TX010295603Medicaid