Provider Demographics
NPI:1720109093
Name:LA PALOMA DME,LLC
Entity Type:Organization
Organization Name:LA PALOMA DME,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:ENID
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-849-5586
Mailing Address - Street 1:2336 E. GRANT STREET SUITE #1
Mailing Address - Street 2:
Mailing Address - City:ROMA
Mailing Address - State:TX
Mailing Address - Zip Code:78584
Mailing Address - Country:US
Mailing Address - Phone:956-846-5586
Mailing Address - Fax:956-849-5528
Practice Address - Street 1:2336 E. GRANT STREET SUITE #1
Practice Address - Street 2:
Practice Address - City:ROMA
Practice Address - State:TX
Practice Address - Zip Code:78584
Practice Address - Country:US
Practice Address - Phone:956-846-5586
Practice Address - Fax:956-849-5528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN NO.