# THE MADDOX SHOP INC

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

## Provider details

- **NPI number:** 1194872531
- **Authorized official:** MR. MARK G SNYDER (PRESIDENT)
- **Authorized official phone:** (214) 328-3009

## Contact information

- **Practice address:** 130 CASA LINDA PLAZA, DALLAS, TX 75218-3411
- **Practice address phone:** (214) 328-3009
- **Practice address fax:** (214) 328-2132
- **Mailing address:** 130 CASA LINDA PLAZA, DALLAS, TX 75218-3411
- **Mailing address phone:** (214) 328-3009
- **Mailing address fax:** (214) 328-2132

## Taxonomy

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

## Other

- **Enumeration date:** 01/05/2007
- **Last updated:** 03/16/2009