Organization
BRAZOS VALLEY MEDICAL EQUIPMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA ANN CHENNAULT (VICEPRESIDENTANDMANAGER)
(936) 348-5709
Entity
Organization
Contact information
Practice address
2644 DERBY LN, MADISONVILLE, TX 77864-4110
(936) 348-5709
(936) 348-5358
Mailing address
2644 DERBY LN, MADISONVILLE, TX 77864-4110
(936) 348-5709
(936) 348-5358
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0041089
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000517267
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/21/2007
Last updated
08/22/2020
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