Texas Rejuvenation Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

TX14767 Issued in TX

Legal business name

TEXAS REJUVENATION MEDICAL SUPPLY, LLC

Practice address

414 W. Grand Pkwy S., Ste B-150
Katy, TX 77494

Phone

(281) 564-9332

Fax

(281) 564-0015

NPI assigned

Jul 9, 2008

Organization subpart

No

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

Authorized official

Name

Mr. William D Smythe

Title

Owner

Phone

(281) 564-9332

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348444800000",
    "number": "1154584001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W. GRAND PKWY S., STE B-150",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "281-564-9332",
            "fax_number": "281-564-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W. GRAND PKWY S., STE B-150",
            "city": "KATY",
            "state": "TX",
            "postal_code": "77494",
            "telephone_number": "281-564-9332",
            "fax_number": "281-564-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS REJUVENATION MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2012-09-24",
        "status": "A",
        "authorized_official_last_name": "SMYTHE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-564-9332",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "TX14767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "202329301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Katy, TX
• Providers in Katy, 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 Sep 24, 2012; 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.