Organization Active NPI

SS Medical Supply

  • Durable Medical Equipment & Medical Supplies
  • Tomball, TX
National Provider Identifier
1710139142
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SS MEDICAL SUPPLY
Practice address
22927 Lily Creek Dr
Tomball, TX 77375-2796
Phone
(281) 251-5635
NPI assigned
Oct 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Authorized official

Name
Mr. Antonio L Holley
Title
Owner
Phone
(281) 251-5635

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X TX Primary

Addresses

Primary practice location

22927 Lily Creek Dr
Tomball, TX 77375-2796

Mailing address

22927 Lily Creek Dr
Tomball, TX 77375-2796
Phone (281) 251-5635

Other identifiers 1

IdentifierTypeStateIssuer
010373701MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1710139142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22927 LILY CREEK DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773752796",
            "telephone_number": "281-251-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22927 LILY CREEK DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773752796",
            "telephone_number": "281-251-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SS MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "HOLLEY",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-251-5635",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010373701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tomball, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.