Organization
LONE STAR SCOOTERS OF LONGVIEW, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY MICHAEL SMITH (PRESIDENT)
(903) 297-2834
Entity
Organization
Contact information
Practice address
2010 GILMER RD, SUITE 103, LONGVIEW, TX 75604-2573
(903) 297-2834
(903) 297-2848
Mailing address
2010 GILMER RD, SUITE 103, LONGVIEW, TX 75604-2573
(903) 297-2834
(903) 297-2848
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0072714
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
452210
JACHO
—
01
—
531025
BCBS
TX
Enumeration date
10/19/2006
Last updated
01/25/2008
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