Provider Demographics
NPI:1144556093
Name:PROFESSIONAL MOBILITY AND DME, INC
Entity type:Organization
Organization Name:PROFESSIONAL MOBILITY AND DME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HAUSBECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-494-9036
Mailing Address - Street 1:224 N MCCOLL RD
Mailing Address - Street 2:SUITE P
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-9371
Mailing Address - Country:US
Mailing Address - Phone:956-682-6377
Mailing Address - Fax:956-682-2586
Practice Address - Street 1:224 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-9371
Practice Address - Country:US
Practice Address - Phone:956-682-6377
Practice Address - Fax:956-682-2586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332BC3200X, 332BX2000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6389570001Medicare NSC