# DYNAMIC MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dynamic Medical Solutions, Intimate Choice Mastectomy Boutique
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679141162
- **Authorized official:** MINERVA L MENDOZA COF, CFO, CMF (MARKETING DIRECTOR)
- **Authorized official phone:** (210) 876-1130

## Contact information

- **Practice address:** 13807 RED MAPLE WOOD STE 201B, SAN ANTONIO, TX 78249-3707
- **Practice address phone:** (210) 876-1130
- **Practice address fax:** (210) 455-1202
- **Mailing address:** 13807 RED MAPLE WOOD STE 201B, SAN ANTONIO, TX 78249-3707
- **Mailing address phone:** (210) 876-1130
- **Mailing address fax:** (210) 455-1202

## Taxonomy

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

## Other

- **Enumeration date:** 06/11/2021
- **Last updated:** 01/31/2023