Provider Demographics
NPI:1417193152
Name:CTXVHCS
Entity Type:Organization
Organization Name:CTXVHCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOTIST/PROSTHETIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:CREAMER
Authorized Official - Suffix:
Authorized Official - Credentials:CP,LPO,FAAOP
Authorized Official - Phone:254-743-2150
Mailing Address - Street 1:1901 VETERANS MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-7451
Mailing Address - Country:US
Mailing Address - Phone:254-743-2150
Mailing Address - Fax:254-743-2348
Practice Address - Street 1:1901 VETERANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:254-743-2150
Practice Address - Fax:254-743-2348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCP#1706,LPO#12224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Single Specialty