# SOUTHEAST TEXAS MEDICAL INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Liberty Medical Mart
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730182049
- **Authorized official:** MRS. JUDY FONTENOT (PRESIDENT)
- **Authorized official phone:** (936) 336-8101

## Contact information

- **Practice address:** 2818B N MAIN ST, LIBERTY, TX 77575-3911
- **Practice address phone:** (936) 336-8101
- **Practice address fax:** (936) 336-7152
- **Mailing address:** PO BOX 10126, LIBERTY, TX 77575-7626
- **Mailing address phone:** (936) 336-8101
- **Mailing address fax:** (936) 336-7152

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0034444 | TX | Yes |

## Other

- **Enumeration date:** 05/31/2005
- **Last updated:** 08/22/2020