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Organization
MAVERICK MEDICAL SUPPLY LLC
Active
Organization
MAVERICK MEDICAL SUPPLY LLC
Active
Other names
Maverick Medical supply
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO ALBERTO DIAZ (MANAGING MEMBER)
(830) 968-7740
Entity
Organization
Contact information
Practice address
2483 2ND ST, STE. F, EAGLE PASS, TX 78852-4390
(830) 757-9000
(830) 757-9002
Mailing address
2483 2ND ST, STE. F, EAGLE PASS, TX 78852-4390
(830) 757-9000
(830) 757-9002
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1000197
TX
Other
Enumeration date
10/02/2009
Last updated
01/28/2021
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