Provider Demographics
NPI:1770985533
Name:SOUTH HOUSTON MED EQUIP LLC
Entity type:Organization
Organization Name:SOUTH HOUSTON MED EQUIP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:713-299-8378
Mailing Address - Street 1:217 GLEN HAVEN DR
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4304
Mailing Address - Country:US
Mailing Address - Phone:713-299-8378
Mailing Address - Fax:832-663-9371
Practice Address - Street 1:217 GLEN HAVEN DR
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-4304
Practice Address - Country:US
Practice Address - Phone:713-299-8378
Practice Address - Fax:832-663-9371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty