Provider Demographics
NPI:1457450231
Name:HOUSTON,TOTAL ORTHOPEDICS P.A
Entity Type:Organization
Organization Name:HOUSTON,TOTAL ORTHOPEDICS P.A
Other - Org Name:ALLIED ORTHOPEDIC & HAND P A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:KELLNER
Authorized Official - Suffix:
Authorized Official - Credentials:CREDENTIALING
Authorized Official - Phone:713-586-6705
Mailing Address - Street 1:PO BOX 924587
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77292-4587
Mailing Address - Country:US
Mailing Address - Phone:713-586-6778
Mailing Address - Fax:713-586-6752
Practice Address - Street 1:110 CYPRESS STATION DR
Practice Address - Street 2:STE 248
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1630
Practice Address - Country:US
Practice Address - Phone:713-586-6705
Practice Address - Fax:713-586-6752
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6403207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0078MYOtherBC BS GROUP NUMBER
TX=========OtherTRICARE
TX0078MYOtherBC BS GROUP NUMBER