Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oxygen Equipment & Supplies |
332BX2000X | B1 | Oxygen supplier | |
Physiological Laboratory, (Independent Physiological Lab) |
293D00000X | 47 | Independent Diagnostic Testing Facility (IDTF) |
| NPI # | 1952585184 |
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| LBN Legal business name | BRAZOS VALLEY CARDIO RESPIRATORY | ||||||||||||
| Authorized official | KEVIN MILLER - (OWNER) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 12/24/2007 | ||||||||||||
| Last updated | 04/09/2009 - About 17 years ago | ||||||||||||
| Identifiers |
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