Provider Demographics
NPI:1255431425
Name:TEXOMA MOBILITY, INC.
Entity type:Organization
Organization Name:TEXOMA MOBILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:KRAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-323-5942
Mailing Address - Street 1:61958 CARNATION RD
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:CO
Mailing Address - Zip Code:81425-9588
Mailing Address - Country:US
Mailing Address - Phone:970-323-5942
Mailing Address - Fax:970-323-5988
Practice Address - Street 1:545 BURK HAWKINS ST STE B
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5187
Practice Address - Country:US
Practice Address - Phone:972-775-4337
Practice Address - Fax:972-775-8580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0085075332BC3200X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27253244Medicaid
TX091567001Medicaid
OK100816020AMedicaid
TX091567002Medicaid
TX091567001Medicaid