# TEXAS REJUVENATION MEDICAL SUPPLY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154584001
- **Authorized official:** MR. WILLIAM D SMYTHE (OWNER)
- **Authorized official phone:** (281) 564-9332

## Contact information

- **Practice address:** 414 W. GRAND PKWY S., STE B-150, KATY, TX 77494
- **Practice address phone:** (281) 564-9332
- **Practice address fax:** (281) 564-0015
- **Mailing address:** 414 W. GRAND PKWY S., STE B-150, KATY, TX 77494
- **Mailing address phone:** (281) 564-9332
- **Mailing address fax:** (281) 564-0015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | TX14767 | TX | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 07/09/2008
- **Last updated:** 09/24/2012