# STRACON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stracon Medical Supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053497008
- **Authorized official:** MR. PHILIP A ADESULU (MANAGING OFFICER)
- **Authorized official phone:** (972) 262-5053

## Contact information

- **Practice address:** 810 DALWORTH ST STE B, GRAND PRAIRIE, TX 75050-5516
- **Practice address phone:** (972) 262-5053
- **Practice address fax:** (972) 262-7160
- **Mailing address:** 810 DALWORTH ST STE B, GRAND PRAIRIE, TX 75050-5516
- **Mailing address phone:** (972) 262-5053
- **Mailing address fax:** (972) 262-7160

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0085290 | TX | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 10/01/2019