Professional DME Services

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROFESSIONAL DME SERVICES

Practice address

26310 Oak Ridge Dr Ste 28
Spring, TX 77380-3777

Phone

(630) 473-4770

NPI assigned

Nov 20, 2023

Organization subpart

No

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

Authorized official

Name

Kalyan Raj Bolla

Title

Authorized Official

Phone

(630) 473-4770

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1457126575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26310 OAK RIDGE DR STE 28",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773803777",
            "telephone_number": "346-606-0327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26310 OAK RIDGE DR STE 28",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773803777",
            "telephone_number": "630-473-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL DME SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "BOLLA",
        "authorized_official_first_name": "KALYAN",
        "authorized_official_middle_name": "RAJ",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "630-473-4770"
    },
    "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 Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.