Organization
MOBILITY ON WHEELS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN JOSE BALTAZAR (PRESIDENT)
(817) 645-9500
Entity
Organization
Contact information
Practice address
1201 E HENDERSON ST, SUITE D, CLEBURNE, TX 76031-5224
(817) 645-9500
(817) 645-7356
Mailing address
1201 E HENDERSON ST, SUITE D, CLEBURNE, TX 76031-5224
(817) 645-9500
(817) 645-7356
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
0052143
TX
Other
Enumeration date
10/17/2006
Last updated
08/22/2020
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