Provider Demographics
NPI:1578562989
Name:ORTHOPAEDIC CENTER OF MIDLAND, PLLC
Entity Type:Organization
Organization Name:ORTHOPAEDIC CENTER OF MIDLAND, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:W
Authorized Official - Last Name:FLOYD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-520-3020
Mailing Address - Street 1:4304 ANDREWS HWY
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79703-4824
Mailing Address - Country:US
Mailing Address - Phone:432-520-3020
Mailing Address - Fax:432-699-1981
Practice Address - Street 1:4304 ANDREWS HWY
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-4824
Practice Address - Country:US
Practice Address - Phone:432-520-3020
Practice Address - Fax:432-699-1981
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2659207X00000X
TXJ1019207X00000X
TXG3641207X00000X
TXK3476207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Not Answered207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1329872021Medicaid
G30020Medicare UPIN
F48563Medicare UPIN
84831JMedicare ID - Type Unspecified
84832JMedicare ID - Type Unspecified
86862KMedicare ID - Type Unspecified
TX1329872021Medicaid
C15629Medicare UPIN
84830JMedicare ID - Type Unspecified