Provider Demographics
NPI:1902945967
Name:ARTEX MEDICAL, INC.
Entity Type:Organization
Organization Name:ARTEX MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:GARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-793-0416
Mailing Address - Street 1:2311 MOORES LN
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-1605
Mailing Address - Country:US
Mailing Address - Phone:903-793-0416
Mailing Address - Fax:903-791-8665
Practice Address - Street 1:2311 MOORES LN
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1605
Practice Address - Country:US
Practice Address - Phone:903-793-0416
Practice Address - Fax:903-791-8665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0028959332B00000X, 332BC3200X, 332BP3500X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0813880001Medicare ID - Type Unspecified