Provider Demographics
NPI:1932205218
Name:TEXAS DURABLE MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:TEXAS DURABLE MEDICAL EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVILA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-462-6211
Mailing Address - Street 1:113 S COMMERCE
Mailing Address - Street 2:
Mailing Address - City:DILLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78017-3501
Mailing Address - Country:US
Mailing Address - Phone:830-965-4900
Mailing Address - Fax:830-965-4911
Practice Address - Street 1:113 S COMMERCE
Practice Address - Street 2:
Practice Address - City:DILLEY
Practice Address - State:TX
Practice Address - Zip Code:78017-3501
Practice Address - Country:US
Practice Address - Phone:830-965-4900
Practice Address - Fax:830-965-4911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142577901OtherTMHP
TX142600901Medicaid
TX142600901Medicaid