# MY NISSI MEDICAL SUPPLIES

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

## Provider details

- **NPI number:** 1174735393
- **Authorized official:** MARTINA SIMI EDEBOR M. ED. (MAEKETING MANAGER)
- **Authorized official phone:** (832) 524-1284

## Contact information

- **Practice address:** 15074 HWY 6, ROSHARON, TX 77583
- **Practice address phone:** (281) 431-6898
- **Practice address fax:** (281) 431-6899
- **Mailing address:** 15074 HWY 6, ROSHARON, TX 77583
- **Mailing address phone:** (281) 431-6898
- **Mailing address fax:** (281) 431-6899

## Taxonomy

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

## Other

- **Enumeration date:** 05/03/2007
- **Last updated:** 08/22/2020