# LINCLON MEDICAL SUPPLY

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

## Provider details

- **NPI number:** 1386839116
- **Authorized official:** MARK EDWARD FARIAS B.S. (MANAGER)
- **Authorized official phone:** (713) 576-6903

## Contact information

- **Practice address:** 4009 BELLAIRE BLVD, \#K, HOUSTON, TX 77025-1168
- **Practice address phone:** (713) 576-6903
- **Mailing address:** PO BOX 10347, CORPUS CHRISTI, TX 78460-0347
- **Mailing address phone:** (713) 576-6903

## Taxonomy

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

## Other

- **Enumeration date:** 09/14/2007
- **Last updated:** 09/14/2007