Organization
MAVERICK MEDICAL SUPPLY LLC
Active
Other names
Maverick Medical supply
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO ALBERTO DIAZ (MANAGING MEMBER)
(830) 968-7740
Entity
Organization
Contact information
Practice address
2483 2ND ST, STE. F, EAGLE PASS, TX 78852-4390
(830) 757-9000
(830) 757-9002
Mailing address
2483 2ND ST, STE. F, EAGLE PASS, TX 78852-4390
(830) 757-9000
(830) 757-9002
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1000197
TX
Other
Enumeration date
10/02/2009
Last updated
01/28/2021
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