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Organization
804 MEDICAL SUPPLY LLC
Active
Organization
804 MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX WILSON (MANAGER)
(902) 608-6717
Entity
Organization
Contact information
Practice address
11011 S WILCREST DR # G210, HOUSTON, TX 77099-4347
(902) 608-6717
Mailing address
11011 S WILCREST DR # G210, HOUSTON, TX 77099-4347
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
Other
Enumeration date
08/27/2026
Last updated
08/27/2026
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