Organization
MIRACLE MEDICAL EQUIPMENT AND SUPPLIES OF SOUTH TEXAS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE LEE LOZANO (CEO)
(956) 969-9596
Entity
Organization
Contact information
Practice address
1020 PALM PARKWAY DR, WESLACO, TX 78596
(956) 969-9596
(956) 969-9569
Mailing address
1020 PALM PARKWAY DR, WESLACO, TX 78596-1203
(956) 969-9596
(956) 969-9569
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0077132
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189411501
—
TX
05
—
189411502
—
TX
Enumeration date
05/09/2007
Last updated
07/25/2018
Update your record
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