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Organization
DIABETIC SHOE SOURCE AND DME
Active
Organization
DIABETIC SHOE SOURCE AND DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIA NOLASCO (MEMBER)
(915) 317-1222
Entity
Organization
Contact information
Practice address
907 CHELSEA ST STE G, EL PASO, TX 79903-4912
(915) 317-1222
(915) 317-1005
Mailing address
907 CHELSEA ST STE G, EL PASO, TX 79903-4912
(915) 317-1222
(915) 317-1005
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
09/12/2026
Last updated
09/17/2026
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