Organization
VICTORY MEDICAL EQUIPMENT OF TX
Active
Parent organization
VICTORY MEDICAL EQUIPMENT OF TX
Organization subpart
Yes
Provider details
NPI number
Legal business name
VICTORY MEDICAL EQUIPMENT OF TX
Authorized official
JUDY K BOLEN (ADMINISTRATOR)
(903) 868-0308
Entity
Organization
Contact information
Practice address
2501 N CENTER ST, SUITE 105, BONHAM, TX 75418-2114
(903) 583-3562
(903) 583-8636
Mailing address
809 GALLAGHER DR, SUITE D, SHERMAN, TX 75090-3111
(903) 868-0308
(903) 868-0207
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0099790
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192165201
—
TX
Enumeration date
09/09/2010
Last updated
09/09/2010
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