Organization
PROFESSIONAL MEDICAL TECH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN PAUL SANDOVAL (PRESIDENT / OWNER)
(956) 664-1272
Entity
Organization
Contact information
Practice address
1901 W HACKBERRY AVE, MCALLEN, TX 78501
(956) 664-1272
(956) 664-2151
Mailing address
1901 W HACKBERRY AVE, MCALLEN, TX 78501
(956) 664-1272
(956) 664-2151
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011194001
TPI NUMBER
TX
05
—
017298301
—
TX
Enumeration date
12/14/2006
Last updated
05/28/2013
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