Willie Nathaniel Long III

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

32010589631 Issued in TX

Practice address

610 Murphy Rd Ste 107
Stafford, TX 77477-5926

Phone

(281) 261-9616

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Health Shack Medical Equipment & Supply Inc.

  • Durable Medical Equipment & Medical Supplies
  • Stafford, TX
  • NPI 1689990137
  NPD (past) Authorized official

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659441194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6214 BERKRIDGE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770533448",
            "telephone_number": "832-335-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 MURPHY RD STE 107",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774775926",
            "telephone_number": "281-261-9616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "WILLIE",
        "middle_name": "NATHANIEL",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "32010589631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Ann Lockhart, LVN
• Patricia Elizabeth Loewenstein, RN
• Oludolapo A Lofinmakin, FNP-C, PMHNP-BC
• Thomas M Lomonte, D.D.S.
• Lonestar Meditex
• Tatiana Lopez Vasquez
• Lotrece Pickett LLC
• Sydney Love
• Harvel Loveless, D.D.S.
• Tiffany Lovett Nasso'Arjona, MS, LPC

• Durable Medical Equipment & Medical Supplies in Stafford, TX
• Providers in Stafford, 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 Jul 8, 2007; 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.