Organization Active NPI

Hacienda DME LLC

  • Durable Medical Equipment & Medical Supplies
  • McAllen, TX
National Provider Identifier
1093744161
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0083512 Issued in TX
Legal business name
HACIENDA DME LLC
Practice address
2408 Buddy Owens Ave
McAllen, TX 78504-5463
Phone
(956) 688-8212
Fax
(956) 467-5589
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Gregorio Garza Garcia
Title
President
Phone
(956) 688-8212

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0083512 TX Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 0083512 TX

Addresses

Primary practice location

2408 Buddy Owens Ave
McAllen, TX 78504-5463

Mailing address

2408 Buddy Owens Ave
McAllen, TX 78504-5463
Phone (956) 688-8212

Other identifiers 2

IdentifierTypeStateIssuer
178212001MedicaidTX
178212002MedicaidTX

National Provider Directory

National Provider Directory

Locations

2408 Buddy Owens Ave
McAllen, TX 78504
Phone (956) 688-8212

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1093744161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 BUDDY OWENS AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785045463",
            "telephone_number": "956-688-8212",
            "fax_number": "956-467-5589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 BUDDY OWENS AVE",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785045463",
            "telephone_number": "956-688-8212",
            "fax_number": "956-467-5589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HACIENDA DME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "GARZA GARCIA",
        "authorized_official_first_name": "GREGORIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "956-688-8212"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0083512",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": "0083512",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178212001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178212002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.