Organization
GULF BIOMECHANICAL LABORATORY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY E MYERS (OWNER/MANAGER)
(210) 495-3399
Entity
Organization
Contact information
Practice address
2101 CRAWFORD, SUITE 203, HOUSTON, TX 77002
(713) 739-1911
(713) 793-7588
Mailing address
4045 E SOUTHCROSS BLVD, SAN ANTONIO, TX 78222-3636
(210) 495-3999
(210) 495-3393
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
101035
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156086401
—
TX
05
—
156086402
—
TX
01
—
530204
BLUE CROSS DME
TX
01
—
530754
BLUE CROSS O & P
TX
Enumeration date
07/25/2006
Last updated
04/12/2019
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