STATESERV MEDICAL OF TEXAS, LLC (NPI# 1245869080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245869080 |
| Entity Type | Organization |
| Organization Name | STATESERV MEDICAL OF TEXAS, LLC |
| Practice Address |
7941 Rodeo Trail Mansfield TX 76063 |
| Mailing Address |
1201 South Alma School Rd Suite 4000 Mesa AZ 85210 |
| Practice Telephone | 8776337250 |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2020-04-03 |
| Authorized Official Name | CHRISTOPHER ROODE (COO) |
| Authorized Official Telephone | 8776337250 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| Street Address |
7941 RODEO TRAIL |
| City | MANSFIELD |
| State | TX |
| Zip Code | 76063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316558349 | Lindsey Vandyke, D.o. Pllc | Internal Medicine | 3150 E Broad Street, Ste 100, Mansfield, TX 76063 | 2020-08-13 |
| 1942819867 | Jennifer Que Chau Nguyen | Pharmacist | 980 U.S. 287 Frontage Rd #287, Mansfield, TX 76063 | 2020-07-27 |
| 1194346890 | Ana Maria Gonzalez | Dentist | 1600 Us Highway 287, Suite 102, Mansfield, TX 76063 | 2020-05-04 |
| 1649802232 | Mary Puanani Kamai | Nurse Practitioner | 1301 E. Debbie Lane, Suite 102 #1405, Mansfield, TX 76063 | 2020-02-11 |
| 1770123028 | Gladys Vera Nfodzo | Nurse Practitioner | 901 W. Broad St, Mansfield, TX 76063 | 2020-01-14 |
| 1669011300 | Alexa Smith | Nurse Practitioner | 2800 E Broad St #304, Mansfield, TX 76063 | 2019-12-28 |
| 1477190437 | Mel Rockwall LLC | Optometrist | 1701 East Broad Street, Ste 109, Mansfield, TX 76063 | 2019-12-09 |
| 1376185512 | Daniel Max & Marcandrea LLC | Optometrist | 1701 East Broad St., Ste 109, Mansfield, TX 76063 | 2019-10-09 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| 1629531421 | Sara Rebecca Pannell | Pharmacist | 3145 East Broad Street, Mansfield, TX 76063 | 2019-04-09 |
| Find all providers in zip 76063 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487135398 | Welch Medical | Durable Medical Equipment & Medical Supplies | 1696 Country Club Dr Ste 101, Mansfield, TX 76063-2625 | 2018-08-28 |
| 1851846760 | Olugbemiga Igbekoyi | Durable Medical Equipment & Medical Supplies | 320 Queens Ct N Apt C, Mansfield, TX 76063-2465 | 2016-08-20 |
| 1467906206 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 741 Scholl Rd Ste P1, Mansfield, OH 44907-1571 | 2016-08-10 |
| 1326408600 | J2r Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 1213 Remington Ranch Rd, Mansfield, TX 76063-5729 | 2016-03-01 |
| 1356713598 | Pedialift LLC | Durable Medical Equipment & Medical Supplies | 475 Overlook Rd, Mansfield, OH 44907-1534 | 2015-10-27 |
| 1346620341 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3802 East Broad St, Mansfield, TX 76063-5617 | 2015-06-04 |
| 1235516931 | Snoring Sleep Apnea and Advanced Sleep Appliance Management LLC | Durable Medical Equipment & Medical Supplies | 1221 S Trimble Rd, Building A, Suite A1, Mansfield, OH 44907-2229 | 2015-05-01 |
| 1568865368 | Wal-mart Stores Inc | Durable Medical Equipment & Medical Supplies | 720 N Hwy 71, Mansfield, AR 72940 | 2014-10-07 |
| 1568802270 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 1740 North Fm 157, Mansfield, TX 76063 | 2013-06-26 |
| 1386081560 | Crystal Maureen Meehan | Durable Medical Equipment & Medical Supplies | 2151 North Holland, Mansfield, TX 76063 | 2013-05-29 |
| Find all providers in MANSFIELD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.