# MIRACLE MEDICAL EQUIPMENT AND SUPPLIES OF SOUTH TEXAS LLC

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

## Provider details

- **NPI number:** 1679787899
- **Authorized official:** JORGE LEE LOZANO (CEO)
- **Authorized official phone:** (956) 969-9596

## Contact information

- **Practice address:** 1020 PALM PARKWAY DR, WESLACO, TX 78596
- **Practice address phone:** (956) 969-9596
- **Practice address fax:** (956) 969-9569
- **Mailing address:** 1020 PALM PARKWAY DR, WESLACO, TX 78596-1203
- **Mailing address phone:** (956) 969-9596
- **Mailing address fax:** (956) 969-9569

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0077132 | TX | Yes |

## Other

- **Enumeration date:** 05/09/2007
- **Last updated:** 07/25/2018