Organization
GREAT AMERICAN SCOOTER COMPANY OF HUMBLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TROY R LILES (CO-OWNER)
(832) 445-0956
Entity
Organization
Contact information
Practice address
2111 FM 1960 RD EAST, HUMBLE, TX 77338-5229
(832) 445-0956
Mailing address
2111 FM 1960 ROAD EAST, HUMBLE, TX 77338
(832) 445-0956
(832) 445-0958
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0071765
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156285202
—
TX
Enumeration date
09/26/2006
Last updated
03/07/2017
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