# MAVERICK MEDICAL SUPPLY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Maverick Medical supply
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861727240
- **Authorized official:** MARIO ALBERTO DIAZ (MANAGING MEMBER)
- **Authorized official phone:** (830) 968-7740

## Contact information

- **Practice address:** 2483 2ND ST, STE. F, EAGLE PASS, TX 78852-4390
- **Practice address phone:** (830) 757-9000
- **Practice address fax:** (830) 757-9002
- **Mailing address:** 2483 2ND ST, STE. F, EAGLE PASS, TX 78852-4390
- **Mailing address phone:** (830) 757-9000
- **Mailing address fax:** (830) 757-9002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 1000197 | TX | Yes |

## Other

- **Enumeration date:** 10/02/2009
- **Last updated:** 01/28/2021