Provider Demographics
NPI:1548493539
Name:ELEGANT MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:ELEGANT MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABHAMAN
Authorized Official - Middle Name:AJEEMDAS
Authorized Official - Last Name:PARMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-973-0402
Mailing Address - Street 1:6525 W SAM HOUSTON PKWY N
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-5104
Mailing Address - Country:US
Mailing Address - Phone:713-466-4500
Mailing Address - Fax:713-466-4501
Practice Address - Street 1:6525W SAM HOUSTON PKY N
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041
Practice Address - Country:US
Practice Address - Phone:713-466-4500
Practice Address - Fax:713-466-4501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6468100001Medicare NSC