Organization
PL MEDICAL SUPPLY, INC
Active
Other names
PRODUCTIVE LIFE MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NOEMI VILLARREAL (VP)
(956) 580-7577
Entity
Organization
Contact information
Practice address
2034 E GRIFFIN PARKWAY, MISSION, TX 78572-3223
(956) 580-7577
(956) 580-9073
Mailing address
2034 E GRIFFIN PARKWAY, MISSION, TX 78572-3223
(956) 580-7577
(956) 580-9073
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0056670
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0056670
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
0056670
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147473601
—
TX
05
—
147473602
—
TX
05
—
147474401
—
TX
01
—
531956
BCBS OF TX PROVIDER NUMBE
TX
Enumeration date
09/13/2006
Last updated
01/04/2022
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