Organization
HACIENDA DME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORIO GARZA GARCIA (PRESIDENT)
(956) 688-8212
Entity
Organization
Contact information
Practice address
2408 BUDDY OWENS AVE, MCALLEN, TX 78504-5463
(956) 688-8212
(956) 467-5589
Mailing address
2408 BUDDY OWENS AVE, MCALLEN, TX 78504-5463
(956) 688-8212
(956) 467-5589
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0083512
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0083512
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178212001
—
TX
05
—
178212002
—
TX
Enumeration date
07/01/2006
Last updated
03/02/2011
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