Active NPI
Hacienda DME LLC
- Durable Medical Equipment & Medical Supplies
- McAllen, TX
National Provider Identifier
1093744161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 0083512
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 178212001 | Medicaid | TX | |
| 178212002 | Medicaid | TX |
National Provider Directory
National Provider DirectoryLocations
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.