Organization
SOUTHERN MEDIC DURABLE EQUIPMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEANDRIA MERRLEN WOOD (OWNER)
(713) 271-3884
Entity
Organization
Contact information
Practice address
10101 HARWIN DR, STE. 369, HOUSTON, TX 77036-1687
(713) 271-3884
(832) 252-1925
Mailing address
10101 HARWIN DR, STE. 369, HOUSTON, TX 77036-1687
(713) 271-3884
(832) 252-1925
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
102259
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194441502
—
TX
01
—
532812
BCBS OF TX
TX
Enumeration date
02/11/2008
Last updated
10/28/2008
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