Provider Demographics
NPI:1467209544
Name:OMEGA 1 DME LLC
Entity type:Organization
Organization Name:OMEGA 1 DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MFON
Authorized Official - Middle Name:
Authorized Official - Last Name:ENYONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-801-0791
Mailing Address - Street 1:10103 FONDREN RD STE 236
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-4649
Mailing Address - Country:US
Mailing Address - Phone:713-485-5173
Mailing Address - Fax:713-485-5716
Practice Address - Street 1:10103 FONDREN RD STE 236
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-4649
Practice Address - Country:US
Practice Address - Phone:713-485-5173
Practice Address - Fax:713-485-5716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies