Prudential Medical Network, LP

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PRUDENTIAL MEDICAL NETWORK, LP

Practice address

5455 Honeysuckle Rd
Midlothian, TX 76065-7006

Phone

(972) 567-9571

Fax

(817) 563-6934

NPI assigned

May 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kelly Dean Sanders, OPA-C

Title

Co President

Phone

(817) 714-9066

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003025784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 HONEYSUCKLE RD",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760657006",
            "telephone_number": "972-567-9571",
            "fax_number": "817-563-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 HONEYSUCKLE RD",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760657006",
            "telephone_number": "972-567-9571",
            "fax_number": "817-563-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENTIAL MEDICAL NETWORK, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CO PRESIDENT",
        "authorized_official_telephone_number": "817-714-9066",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OPA-C"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Megan Elizabeth Proudfoot, RN
• Alison Renee Pugh, LCSW
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• Radiological Consultants Association
• Randalls Food & Drugs LP

• Durable Medical Equipment & Medical Supplies in Midlothian, TX
• Providers in Midlothian, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.