Tri-Star Medical Equipment & Supplies, Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

License

0068415 Issued in TX

Legal business name

TRI-STAR MEDICAL EQUIPMENT & SUPPLIES, INC.

Practice address

4660 S State Highway 360
Ste 130
Grand Prairie, TX 75052-4492

Phone

(972) 988-9600

Fax

(972) 988-9601

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven Douglas Watkins

Title

President

Phone

(817) 919-0311

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164529137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4660 S STATE HIGHWAY 360",
            "address_2": "STE 130",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524492",
            "telephone_number": "972-988-9600",
            "fax_number": "972-988-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4660 S STATE HIGHWAY 360",
            "address_2": "STE 130",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524492",
            "telephone_number": "972-988-9600",
            "fax_number": "972-988-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STAR MEDICAL EQUIPMENT & SUPPLIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-919-0311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TX",
            "license": "0068415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "531350",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• 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.