# TEXAS INCONTINENCE SUPPLY LLC

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

## Provider details

- **NPI number:** 1194164889
- **Authorized official:** MR. VICENTE DOMINGUEZ II (OWNER)
- **Authorized official phone:** (806) 789-6963

## Contact information

- **Practice address:** 8820 14TH ST, LUBBOCK, TX 79416-6218
- **Practice address phone:** (806) 789-6963
- **Mailing address:** 8820 14TH ST, LUBBOCK, TX 79416-6218
- **Mailing address phone:** (806) 789-6963

## Taxonomy

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

## Other

- **Enumeration date:** 06/17/2013
- **Last updated:** 06/17/2013