Healthcare Professionals:

Durable Medical Equipment (DME):

Fax Number: (817) 338-0816

Phone Number: (817) 338-0007

Home Infusion:

Fax Number: (888) 249-3132

Phone Number: (866) 388-3883

Order Form Links:

DME - COVID 02 Insurance Order Form

DME - Medicaid Advantage O2 Form

DME - Medicare CMN - Initial Form

DME - TMHP Medicaid O2 Form

Infusion - ABX Order Form

Insurance List:

Insurance List

Infusion - Medicaid Title XIX ABX Supply Form

Infusion - Medicaid Title XIX TPN Order Form

Infusion - TPN Order Form

Infusion - Hizentra Order Form

Infusion - Enteral Nutrition Order Form