NPIMap

Organization Active NPI

PL Medical Supply, Inc

  • Durable Medical Equipment & Medical Supplies
  • Mission, TX
National Provider Identifier
1992800411
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0056670 Issued in TX
Legal business name
PL MEDICAL SUPPLY, INC
Practice address
2034 E Griffin Parkway
Mission, TX 78572-3223
Phone
(956) 580-7577
Fax
(956) 580-9073
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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

Authorized official

Name
Mrs. Noemi Villarreal
Title
VP
Phone
(956) 580-7577

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0056670 TX Primary
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 0056670 TX
Oxygen Equipment & Supplies (DME) 332BX2000X 0056670 TX

Addresses

Primary practice location

2034 E Griffin Parkway
Mission, TX 78572-3223

Mailing address

2034 E Griffin Parkway
Mission, TX 78572-3223
Phone (956) 580-7577

Other identifiers 4

IdentifierTypeStateIssuer
147473601MedicaidTX
147474401MedicaidTX
147473602MedicaidTX
531956OtherTXBCBS OF TX PROVIDER NUMBE

Other names 1

  • PRODUCTIVE LIFE MEDICAL SUPPLY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930085964 TX DME Supplier - Medical Supply Company 3274738984 Practice locations: Mission, TX

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
PL Medical Supply Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641254400000",
    "number": "1992800411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 E GRIFFIN PARKWAY",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723223",
            "telephone_number": "956-580-7577",
            "fax_number": "956-580-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 E GRIFFIN PARKWAY",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785723223",
            "telephone_number": "956-580-7577",
            "fax_number": "956-580-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PL MEDICAL SUPPLY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A",
        "authorized_official_last_name": "VILLARREAL",
        "authorized_official_first_name": "NOEMI",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "956-580-7577",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0056670",
            "primary": true
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": "0056670",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TX",
            "license": "0056670",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147473601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147474401",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "147473602",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TX PROVIDER NUMBE",
            "identifier": "531956",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRODUCTIVE LIFE MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PRODUCTIVE LIFE MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.