Provider Demographics
NPI:1447679618
Name:SR DME HOLDINGS, LLC
Entity type:Organization
Organization Name:SR DME HOLDINGS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-798-3172
Mailing Address - Street 1:PO BOX 4346
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4346
Mailing Address - Country:US
Mailing Address - Phone:281-364-1122
Mailing Address - Fax:281-210-2405
Practice Address - Street 1:20639 KUYKENDAHL ROAD
Practice Address - Street 2:BUILDING A
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-3376
Practice Address - Country:US
Practice Address - Phone:281-036-4112
Practice Address - Fax:281-210-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001252332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment