Organization
DURA MEDIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIM TIDD (AUTHORIZED OFFICIAL)
(512) 320-5400
Entity
Organization
Contact information
Practice address
3601 S CONGRESS AVE, STE B-400B, AUSTIN, TX 78704
(512) 320-5400
(512) 320-9961
Mailing address
PO BOX 2728, AUSTIN, TX 78768-2728
(512) 320-5400
(512) 320-9961
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
TX
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528358
—
LA
05
—
1664401
—
TX
01
—
531707
BCBS TEXAS
TX
05
—
XDME03175
—
CA
Enumeration date
06/30/2005
Last updated
07/21/2022
Update your record
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