Maverick Medical Supply LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1000197 Issued in TX

Legal business name

MAVERICK MEDICAL SUPPLY LLC

Practice address

2483 2ND St
Ste. F
Eagle Pass, TX 78852-4390

Phone

(830) 757-9000

Fax

(830) 757-9002

NPI assigned

Oct 2, 2009

Organization subpart

No

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

Authorized official

Name

Mario Alberto Diaz

Title

Managing Member

Phone

(830) 968-7740

Specialties & licenses 1

Addresses

Other names 1

• Maverick Medical supply Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1254441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1861727240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2483 2ND ST",
            "address_2": "STE. F",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524390",
            "telephone_number": "830-757-9000",
            "fax_number": "830-757-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2483 2ND ST",
            "address_2": "STE. F",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788524390",
            "telephone_number": "830-757-9000",
            "fax_number": "830-757-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVERICK MEDICAL SUPPLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-02",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "ALBERTO",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "830-968-7740"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1000197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maverick Medical supply",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Maverick Medical supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maverick County Hospital District
• Maverick County Hospital District
• Maverick County Medical Family Center
• Maverick County Rural Radiologists P a
• Maverick Emergency Medicine Associates PA
• Maverick Physician Services PA
• McCrae Management and Investments, LTD.
• Med Shield Ambulance, Inc.
• Medcare Ambulance, LLC
• Medi-Cab Express of Texas, LP

• Durable Medical Equipment & Medical Supplies in Eagle Pass, TX
• Providers in Eagle Pass, 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 Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.