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Organization

TRICARE MEDICAL EQUIPMENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WANDA LAWLESS (OFFICER/OWNER)
(806) 894-0144
Entity
Organization

Contact information

Practice address
1500 N BRYAN AVE, LAMESA, TX 79331-3143
(806) 872-3837
(806) 872-7457
Mailing address
PO BOX 476, LEVELLAND, TX 79336-0476
(806) 894-0144
(806) 894-6777

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015824802
TX
05
015824803
TX
Enumeration date
04/02/2008
Last updated
02/24/2010
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