Provider Demographics
NPI:1326049370
Name:ORTHOPEDIC CLINIC OF GALVESTON COUNTY ASSOCIATES
Entity Type:Organization
Organization Name:ORTHOPEDIC CLINIC OF GALVESTON COUNTY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUMMER
Authorized Official - Middle Name:R
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-938-8161
Mailing Address - Street 1:6501 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-4015
Mailing Address - Country:US
Mailing Address - Phone:409-938-8161
Mailing Address - Fax:409-938-0837
Practice Address - Street 1:6501 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-4015
Practice Address - Country:US
Practice Address - Phone:409-938-8161
Practice Address - Fax:409-938-0837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125226900OtherDEPT OF LABOR
TX081617502Medicaid
TX200026746OtherRR MEDICARE
TX081617501Medicaid
TX540189OtherUHC
TX200000325OtherRR MEDICARE
TX081617502Medicaid
TX833915Medicare PIN
TX200026746OtherRR MEDICARE
TX125226900OtherDEPT OF LABOR
TX00AE99Medicare ID - Type Unspecified