Organization
JTW MEDICAL PRODUCTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN THOMAS WALL III (PRESIDENT)
(214) 325-5679
Entity
Organization
Contact information
Practice address
5228 W PLANO PKWY, PLANO, TX 75093-5005
(972) 250-5738
Mailing address
4760 PRESTON RD, SUITE 244-289, FRISCO, TX 75034-8548
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0040198
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
531299
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/23/2007
Last updated
03/06/2008
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