Southern Medic Durable Equipment

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

License

102259 Issued in TX

Legal business name

SOUTHERN MEDIC DURABLE EQUIPMENT

Practice address

10101 Harwin Dr
Ste. 369
Houston, TX 77036-1687

Phone

(713) 271-3884

Fax

(832) 252-1925

NPI assigned

Feb 11, 2008

Last updated

Oct 28, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Deandria Merrlen Wood

Title

Owner

Phone

(713) 271-3884

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1558539684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 HARWIN DR",
            "address_2": "STE. 369",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770361687",
            "telephone_number": "713-271-3884",
            "fax_number": "832-252-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 HARWIN DR",
            "address_2": "STE. 369",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770361687",
            "telephone_number": "713-271-3884",
            "fax_number": "832-252-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MEDIC DURABLE EQUIPMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "DEANDRIA",
        "authorized_official_middle_name": "MERRLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "713-271-3884"
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": "102259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194441502",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX",
            "identifier": "532812",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Parenteral & Enteral Nutrition Supplies (DME) in Houston, TX
• Providers in Houston, TX by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.