Provider Demographics
NPI:1033462767
Name:MEDICAL CITY BRACE & LIMB, PLLC
Entity Type:Organization
Organization Name:MEDICAL CITY BRACE & LIMB, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PROSTHETIST
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPARKS
Authorized Official - Suffix:
Authorized Official - Credentials:BS, CP, LP
Authorized Official - Phone:713-748-0250
Mailing Address - Street 1:8239 ALMEDA RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-4101
Mailing Address - Country:US
Mailing Address - Phone:713-748-0250
Mailing Address - Fax:713-748-0840
Practice Address - Street 1:8239 ALMEDA RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4101
Practice Address - Country:US
Practice Address - Phone:713-748-0250
Practice Address - Fax:713-748-0840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-18
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101422335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier