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Organization
TEXAS MEDICAL SUPPLIES AND REHABILITATION NETWORK
Active
Organization
TEXAS MEDICAL SUPPLIES AND REHABILITATION NETWORK
Active
Other names
Tx medical supplies & Rehab network
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS B FOMUKONG (OWNER)
(972) 272-5820
Entity
Organization
Contact information
Practice address
2433 GOLDFINCH LN, GARLAND, TX 75042-8022
(972) 272-5820
(972) 272-5820
Mailing address
2433 GOLDFINCH LN, GARLAND, TX 75042-8022
(972) 272-5820
(972) 272-5820
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
0080220
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1734238
—
TX
Enumeration date
11/03/2006
Last updated
08/22/2020
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