Provider Demographics
NPI:1770525214
Name:P & F MEDICAL SUPPLY
Entity type:Organization
Organization Name:P & F MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCISCA
Authorized Official - Middle Name:MBANAJA
Authorized Official - Last Name:SIMIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-943-0013
Mailing Address - Street 1:2719 W. 15TH STREET
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075
Mailing Address - Country:US
Mailing Address - Phone:972-943-0013
Mailing Address - Fax:972-943-0014
Practice Address - Street 1:2719 W. 15TH STREET
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075
Practice Address - Country:US
Practice Address - Phone:972-943-0013
Practice Address - Fax:972-943-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32002607763332B00000X
TX0064001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154653301Medicaid
TX154653302Medicaid
TX154653302Medicaid