Provider Demographics
NPI:1265567986
Name:LIBERTY DME
Entity type:Organization
Organization Name:LIBERTY DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GENOVEVA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DE ALEJANDRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-668-1888
Mailing Address - Street 1:804 PECAN BLVD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2453
Mailing Address - Country:US
Mailing Address - Phone:956-668-1888
Mailing Address - Fax:956-668-1898
Practice Address - Street 1:804 PECAN BLVD
Practice Address - Street 2:SUITE 6
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2453
Practice Address - Country:US
Practice Address - Phone:956-668-1888
Practice Address - Fax:956-668-1898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies