Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
FAYETTE MEDICAL SUPPLY, INC.
Active
Organization
FAYETTE MEDICAL SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN HERNANDEZ (OPERATIONS MANAGER)
(979) 968-6680
Entity
Organization
Contact information
Practice address
362 E TRAVIS ST, LA GRANGE, TX 78945-2619
(979) 968-6680
(979) 404-6082
Mailing address
PO BOX 939, LA GRANGE, TX 78945-0939
(979) 968-6680
(979) 859-7184
Taxonomy
Speciality
Code
Description
License number
State
225CA2500X
Assistive Technology Supplier Rehabilitation Counselor
—
NULL
225CA2500X
Assistive Technology Supplier Rehabilitation Counselor
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0031424
TX
Other
Enumeration date
04/17/2006
Last updated
10/02/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers