Provider Demographics
NPI:1467460881
Name:DIABETECH, LP
Entity type:Organization
Organization Name:DIABETECH, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCMAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-235-1668
Mailing Address - Street 1:6301 GASTON AVE
Mailing Address - Street 2:STE 158P
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3922
Mailing Address - Country:US
Mailing Address - Phone:877-694-5826
Mailing Address - Fax:866-434-7314
Practice Address - Street 1:6301 GASTON AVE
Practice Address - Street 2:STE 158P
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-3922
Practice Address - Country:US
Practice Address - Phone:877-694-5826
Practice Address - Fax:866-434-7314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies