Provider Demographics
NPI:1669614681
Name:CROWN SCRUBS & MED SUPPLY
Entity type:Organization
Organization Name:CROWN SCRUBS & MED SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARKAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-293-8633
Mailing Address - Street 1:2376 S DAIRY ASHFORD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5718
Mailing Address - Country:US
Mailing Address - Phone:281-293-8633
Mailing Address - Fax:281-293-8633
Practice Address - Street 1:2376 S DAIRY ASHFORD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5718
Practice Address - Country:US
Practice Address - Phone:281-293-8633
Practice Address - Fax:281-293-8633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0109819332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies