Liberty DME, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

LIBERTY DME, LLC

Practice address

1708 Mozelle St
Pharr, TX 78577-7450

Phone

(956) 783-4804

Fax

(956) 783-4805

NPI assigned

Jun 17, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Javier Trevino, RRT

Title

Owner/Administrator

Phone

(956) 783-4804

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642723200000",
    "number": "1245467240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 MOZELLE ST",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785777450",
            "telephone_number": "956-783-4804",
            "fax_number": "956-783-4805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 MOZELLE ST",
            "city": "PHARR",
            "state": "TX",
            "postal_code": "785777450",
            "telephone_number": "956-783-4804",
            "fax_number": "956-783-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY DME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "956-783-4804",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT"
    },
    "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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• Durable Medical Equipment & Medical Supplies in Pharr, TX
• Providers in Pharr, 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 Jan 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.