Organization
SPECIAL NEEDS SOLUTIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAY BOCKOVER ATP (MANAGER)
(903) 330-0821
Entity
Organization
Contact information
Practice address
13213 HWY 155 S, SUITE B, TYLER, TX 75703-6561
(903) 330-0821
Mailing address
13213 HWY 155 S, SUITE B, TYLER, TX 75703-6561
(903) 330-0821
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162607601
—
TX
05
—
162618602
—
TX
05
—
162618603
—
TX
05
—
162618604
—
TX
05
—
162618605
—
TX
05
—
162618606
—
TX
01
—
531822
BLUECROSS BLUESHIELD
TX
Enumeration date
11/10/2006
Last updated
08/23/2011
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