Provider Demographics
NPI:1952558900
Name:CENTEX EASY LINK MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:CENTEX EASY LINK MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONNY
Authorized Official - Middle Name:CHIMEH
Authorized Official - Last Name:UWAKWEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-539-7000
Mailing Address - Street 1:1202 FM 685
Mailing Address - Street 2:SUITE B3
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-2906
Mailing Address - Country:US
Mailing Address - Phone:512-539-7000
Mailing Address - Fax:512-670-9098
Practice Address - Street 1:17433 DORNACH DRIVE
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-1704
Practice Address - Country:US
Practice Address - Phone:512-639-7000
Practice Address - Fax:512-670-9098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0105366332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies