Provider Demographics
NPI:1245416163
Name:T&L MEDICAL SUPPLY INCORPORATED
Entity type:Organization
Organization Name:T&L MEDICAL SUPPLY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUWOLE
Authorized Official - Middle Name:AYODEJI
Authorized Official - Last Name:BODEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-899-1807
Mailing Address - Street 1:8035 E RL THRTN FWY
Mailing Address - Street 2:SUITE 414
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-7018
Mailing Address - Country:US
Mailing Address - Phone:214-320-8300
Mailing Address - Fax:214-320-8301
Practice Address - Street 1:8035 E RL THRTN FWY
Practice Address - Street 2:SUITE 414
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7018
Practice Address - Country:US
Practice Address - Phone:214-320-8300
Practice Address - Fax:214-320-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies