Active NPI
Heavenly Angels Durable Medical Supplies
- Durable Medical Equipment & Medical Supplies
- Bryan, TX
National Provider Identifier
1801073705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 0089725
- Legal business name
- HEAVENLY ANGELS DURABLE MEDICAL SUPPLIES
- Practice address
- 1706 E 29TH St
Ste. 103
Bryan, TX 77802-1425 - Phone
- (979) 823-5200
- NPI assigned
- Jan 23, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Angel Michelle Reed
- Title
- Owner
- Phone
- (979) 823-5200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 0089725 | TX | Primary |
Addresses
Primary practice location
1706 E 29TH St
Ste. 103
Bryan, TX 77802-1425
Mailing address
1706 E 29TH St
Ste. 103
Bryan, TX 77802-1425
Phone (979) 823-5200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 183214901 | Medicaid | TX |
National Provider Directory
National Provider DirectoryLocations
1706 E 29th St
Ste 103
Bryan, TX 77802
Phone (979) 823-5200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201046400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1225238400000",
"number": "1801073705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1706 E 29TH ST",
"address_2": "STE. 103",
"city": "BRYAN",
"state": "TX",
"postal_code": "778021425",
"telephone_number": "979-823-5200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1706 E 29TH ST",
"address_2": "STE. 103",
"city": "BRYAN",
"state": "TX",
"postal_code": "778021425",
"telephone_number": "979-823-5200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEAVENLY ANGELS DURABLE MEDICAL SUPPLIES",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-23",
"last_updated": "2008-10-29",
"status": "A",
"authorized_official_last_name": "REED",
"authorized_official_first_name": "ANGEL",
"authorized_official_middle_name": "MICHELLE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "979-823-5200",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TX",
"license": "0089725",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "183214901",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 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.