American Eagle Medical Supply
Organization Active NPI Durable Medical Equipment & Medical Supplies · Vidor, TX
NPI 1598038564 · NPPES record last updated Feb 21, 2012
Key facts
- NPI
- 1598038564
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 1000851 (TX)
- Legal business name
- AMERICAN EAGLE MEDICAL SUPPLY
- Practice address
- 2612 N Main St
Vidor, TX 77662-2674 - Phone
- (409) 769-3897
- Fax
- (409) 783-9758
- NPI assigned
- Feb 21, 2012
- Organization subpart
- No
Authorized official
- Name
- Jason M Holmes
- Title
- Owner
- Phone
- (409) 769-3897
National Provider Directory
Locations
2612 N Main St
Vidor, TX 77662
Phone (409) 769-3897
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 1000851 | TX | Yes |
Addresses
Primary practice location
2612 N Main St
Vidor, TX 77662-2674
Mailing address
2612 N Main St
Vidor, TX 77662-2674
Phone (409) 769-3897
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000851 | Other | TX | TEXAS REGULATORY LICENSE |
Other providers in Vidor, TX
All providers in Vidor, TX · Durable Medical Equipment & Medical Supplies in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.