Provider Demographics
NPI:1417313065
Name:CENTER FOR PROSTHETICS & ORTHOTICS
Entity Type:Organization
Organization Name:CENTER FOR PROSTHETICS & ORTHOTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:DARM
Authorized Official - Suffix:
Authorized Official - Credentials:CPO,LPO,CPED
Authorized Official - Phone:210-593-0317
Mailing Address - Street 1:10609 W IH 10 STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1673
Mailing Address - Country:US
Mailing Address - Phone:210-593-0317
Mailing Address - Fax:210-593-0358
Practice Address - Street 1:10609 W IH 10 STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-1673
Practice Address - Country:US
Practice Address - Phone:210-593-0317
Practice Address - Fax:210-593-0358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-12
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier