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Organization

RESPIRA MEDICAL, LP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BRENDA HORNYAK (PRESIDENT)
(817) 695-6900
Entity
Organization

Contact information

Practice address
102 COMMANDER DR, STE 7-8, LONGVIEW, TX 75605-4670
(903) 753-9961
(903) 753-9976
Mailing address
1502 HOUSTON ST, SUITE100, GRAND PRAIRIE, TX 75050-5200
(817) 695-6900
(817) 695-6901

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0081452
TX
332BC3200X
Customized Equipment (DME)
1000043
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
147875
SUPERIOR HEALTH
TX
05
204449701
TX
05
204449702
TX
01
533213
BLUE CROSS BLUE SHIELD
TX
01
7824752
AETNA PRIVATE INSURANCE
TX
Enumeration date
02/17/2009
Last updated
06/21/2011
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