Provider Demographics
NPI:1710635305
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:
Authorized Official - Last Name:DARM
Authorized Official - Suffix:
Authorized Official - Credentials:LPO/CPO
Authorized Official - Phone:210-593-0317
Mailing Address - Street 1:10609 W IH 10
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230
Mailing Address - Country:US
Mailing Address - Phone:830-315-3276
Mailing Address - Fax:210-593-0358
Practice Address - Street 1:420 WATER STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-5200
Practice Address - Country:US
Practice Address - Phone:830-315-3276
Practice Address - Fax:210-593-0358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR PROSTHETICS & ORTHOTICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101721OtherTEXAS ORTHOTIC/PROSTHETIC LICENSE