Provider Demographics
NPI:1306019989
Name:ORTHO ADVANCE LLC
Entity Type:Organization
Organization Name:ORTHO ADVANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-456-5600
Mailing Address - Street 1:25003 PITKIN RD
Mailing Address - Street 2:SUITE E500
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-2610
Mailing Address - Country:US
Mailing Address - Phone:832-456-5600
Mailing Address - Fax:832-456-5602
Practice Address - Street 1:25003 PITKIN RD
Practice Address - Street 2:SUITE E500
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2610
Practice Address - Country:US
Practice Address - Phone:832-456-5600
Practice Address - Fax:832-456-5602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-04
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6166650001Medicare NSC