Provider Demographics
NPI:1912058850
Name:PULMONARY INNOVATION SPECIALISTS
Entity type:Organization
Organization Name:PULMONARY INNOVATION SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:O'DELLE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:512-249-7120
Mailing Address - Street 1:601 S BELL BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3854
Mailing Address - Country:US
Mailing Address - Phone:512-249-7120
Mailing Address - Fax:
Practice Address - Street 1:601 S BELL BLVD
Practice Address - Street 2:STE B
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3854
Practice Address - Country:US
Practice Address - Phone:512-249-7120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0094928332B00000X, 253Z00000X, 251E00000X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health