Maverick Medical Supply LLC
Durable Medical Equipment & Medical Supplies in Eagle Pass, TX. Organization (NPI-2).
NPI number1861727240
StatusActive
Last updated in NPPESJan 28, 2021
Details
- NPI
- 1861727240
- Entity type
- Organization (NPI-2)
- Legal business name
- Maverick Medical Supply LLC
- Organization subpart
- No
- Enumeration date
- Oct 2, 2009
- Certification date
- Jan 28, 2021
- Last updated
- Jan 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | 1000197 | TX | Yes |
Other names
- Maverick Medical Supply (Doing Business As)
Practice location
2483 2nd StSte. F
Eagle Pass, TX 78852-4390
Phone 830-757-9000 · Fax 830-757-9002
Mailing address
2483 2nd StSte. F
Eagle Pass, TX 78852-4390
Phone 830-757-9000 · Fax 830-757-9002
Authorized official
Mario Alberto Diaz
Managing Member
8309687740
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