1497758361 NPI number — ACCURATE MEDICAL EQUIPMENT & SUPPLY CO INC

Table of content: KARLA DE LA CRUZ (NPI 1962075309)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497758361 NPI number — ACCURATE MEDICAL EQUIPMENT & SUPPLY CO INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCURATE MEDICAL EQUIPMENT & SUPPLY CO INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497758361
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 HEMPHILL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FORT WORTH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76104-2252
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-882-1111
Provider Business Mailing Address Fax Number:
817-882-1118

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
550 HEMPHILL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT WORTH
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76104-2252
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-882-1111
Provider Business Practice Location Address Fax Number:
817-882-1118
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
REEVES
Authorized Official First Name:
SHANNON
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
PRESIDENT CEO
Authorized Official Telephone Number:
817-878-5030

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 333600000X , with the licence number: 13285 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0014052730002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 143915 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 81602800 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 509449 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 6014617 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1531677 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4581931 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0220255 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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