Provider Demographics
NPI:1457126575
Name:PROFESSIONAL DME SERVICES
Entity Type:Organization
Organization Name:PROFESSIONAL DME SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARIYAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-606-0327
Mailing Address - Street 1:26310 OAK RIDGE DR STE 28
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3777
Mailing Address - Country:US
Mailing Address - Phone:346-606-0327
Mailing Address - Fax:
Practice Address - Street 1:26310 OAK RIDGE DR STE 28
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3777
Practice Address - Country:US
Practice Address - Phone:346-606-0327
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies