Provider Demographics
NPI:1356349658
Name:TMC ORTHOPEDIC RENTALS LP
Entity type:Organization
Organization Name:TMC ORTHOPEDIC RENTALS LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BROUSSARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-669-1800
Mailing Address - Street 1:1000 SOUTH LOOP WEST
Mailing Address - Street 2:STE 140
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4658
Mailing Address - Country:US
Mailing Address - Phone:713-669-1800
Mailing Address - Fax:
Practice Address - Street 1:1000 SOUTH LOOP WEST
Practice Address - Street 2:STE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4658
Practice Address - Country:US
Practice Address - Phone:713-669-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TMC ORTHOPEDIC RENTALS LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-07-11
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0043845332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4531700001Medicare NSC