Provider Demographics
NPI:1154506046
Name:MOBILITY ORTHOTICS AND PROSTHETICS
Entity Type:Organization
Organization Name:MOBILITY ORTHOTICS AND PROSTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOOK
Authorized Official - Suffix:
Authorized Official - Credentials:LPO
Authorized Official - Phone:817-201-4788
Mailing Address - Street 1:5720 VALLEY ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALVARADO
Mailing Address - State:TX
Mailing Address - Zip Code:76009
Mailing Address - Country:US
Mailing Address - Phone:817-783-2757
Mailing Address - Fax:817-783-2758
Practice Address - Street 1:5720 VALLEY ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ALVARADO
Practice Address - State:TX
Practice Address - Zip Code:76009
Practice Address - Country:US
Practice Address - Phone:817-783-2757
Practice Address - Fax:817-783-2758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101248332B00000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX532746OtherBLUE CROSS BLUE SHIELD
TX101248OtherSTATE OF TEXAS FACILITY ACCREDITATION
TX192150401Medicaid
TX6059050001Medicare NSC