Provider Demographics
NPI:1639296239
Name:MEDICAL CENTER BRACE AND LIMB
Entity Type:Organization
Organization Name:MEDICAL CENTER BRACE AND LIMB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NORMA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-799-1177
Mailing Address - Street 1:7110 CECIL ST
Mailing Address - Street 2:P.O. BOX 301129
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4904
Mailing Address - Country:US
Mailing Address - Phone:713-799-1177
Mailing Address - Fax:713-797-6561
Practice Address - Street 1:7110 CECIL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-799-1177
Practice Address - Fax:713-797-6561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0601280001Medicare ID - Type Unspecified