Selina R Pena

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0093296 Issued in TX

Legal business name

SELINA R PENA

Doing business as

GONZALEZ MEDICAL EQUIPMENT

Practice address

4219 W Expressway 83
Ste D
Mission, TX 78572-8996

Phone

(956) 631-7761

Fax

(956) 631-7961

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Selina Renee Pena

Title

Owner

Phone

(956) 631-7761

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• GONZALEZ MEDICAL EQUIPMENT Doing business as

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1972638617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4219 W EXPRESSWAY 83",
            "address_2": "STE D",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785728996",
            "telephone_number": "956-631-7761",
            "fax_number": "956-631-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4219 W EXPRESSWAY 83",
            "address_2": "STE D",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785728996",
            "telephone_number": "956-631-7761",
            "fax_number": "956-631-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELINA R PENA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "PENA",
        "authorized_official_first_name": "SELINA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "956-631-7761"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0093296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188746502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188746501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GONZALEZ MEDICAL EQUIPMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Mission, TX
• Providers in Mission, 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 Nov 19, 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.