Individual
MR. ROY ALLEN MOLL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
161 MAIN ST, DEPORT, TX 75435-2560
(903) 209-8981
Mailing address
161 MAIN ST, DEPORT, TX 75435-2560
(903) 209-8981
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1002614
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002614
TEXAS DME LICENSE
TX
Enumeration date
04/16/2022
Last updated
04/16/2022
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