# KILLEEN DME SUPPLIES LLC

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

## Provider details

- **NPI number:** 1720905094
- **Authorized official:** TAVARES BOAZ SMITH (OWNER)
- **Authorized official phone:** (713) 912-0654

## Contact information

- **Practice address:** 4501 EMBERS DR, KILLEEN, TX 76542-4500
- **Practice address phone:** (713) 912-0654
- **Practice address fax:** (608) 707-0009
- **Mailing address:** 4501 EMBERS DR, KILLEEN, TX 76542-4500
- **Mailing address phone:** (713) 912-0654
- **Mailing address fax:** (608) 707-0009

## Taxonomy

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

## Other

- **Enumeration date:** 06/30/2026
- **Last updated:** 06/30/2026