Medvanta Medical Supplies
Durable Medical Equipment & Medical Supplies, Customized Equipment in Houston, TX. Organization (NPI-2).
NPI number1104722594
StatusActive
Last updated in NPPESOct 14, 2026
Details
- NPI
- 1104722594
- Entity type
- Organization (NPI-2)
- Legal business name
- Medvanta Medical Supplies
- Organization subpart
- No
- Enumeration date
- Oct 14, 2026
- Certification date
- Oct 14, 2026
- Last updated
- Oct 14, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332BC3200X | Durable Medical Equipment & Medical Supplies, Customized Equipment | – | – | Yes |
| 261QU0200X | Clinic/Center, Urgent Care | – | – |
Practice location
15550 Kingfield DrHouston, TX 77084-6200
Phone 515-565-0276
Mailing address
5900 Balcones DrAustin, TX 78731-4257
Phone 515-565-0276
Authorized official
Michael Angelos
Manager
5155650276
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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