Organization
LA BASE MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALLISTUS EZEAKOR (OWNER)
(713) 518-9360
Entity
Organization
Contact information
Practice address
9302 EAGLEWOOD GLEN TRL, HOUSTON, TX 77083-6285
(713) 518-9360
(281) 302-6897
Mailing address
7770 HIGHWAY 6 S # 367, HOUSTON, TX 77083-3319
(713) 518-9360
(281) 302-6897
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1000491
TX
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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