Miracle Medical Equipment and Supplies of South Texas LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0077132 Issued in TX

Legal business name

MIRACLE MEDICAL EQUIPMENT AND SUPPLIES OF SOUTH TEXAS LLC

Practice address

1020 Palm Parkway Dr
Weslaco, TX 78596

Phone

(956) 969-9596

Fax

(956) 969-9569

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Jorge Lee Lozano

Title

Ceo

Phone

(956) 969-9596

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1679787899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 PALM PARKWAY DR",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "785961203",
            "telephone_number": "956-969-9596",
            "fax_number": "956-969-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 PALM PARKWAY DR",
            "city": "WESLACO",
            "state": "TX",
            "postal_code": "78596",
            "telephone_number": "956-969-9596",
            "fax_number": "956-969-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE MEDICAL EQUIPMENT AND SUPPLIES OF SOUTH TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "LOZANO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "956-969-9596"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0077132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189411501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189411502",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Weslaco, TX
• Providers in Weslaco, 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 25, 2018; 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.