Organization
PROFESSIONAL DME SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALYAN RAJ BOLLA (AUTHORIZED OFFICIAL)
(630) 473-4770
Entity
Organization
Contact information
Practice address
26310 OAK RIDGE DR STE 28, SPRING, TX 77380-3777
(630) 473-4770
Mailing address
26310 OAK RIDGE DR STE 28, SPRING, TX 77380-3777
(346) 606-0327
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
12/03/2024
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