Provider Demographics
NPI:1730287046
Name:HAUSER ORTHOTICS & PROSTHETICS, INC.
Entity Type:Organization
Organization Name:HAUSER ORTHOTICS & PROSTHETICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUSS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:CP
Authorized Official - Phone:936-441-1133
Mailing Address - Street 1:507 WACO ST
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-2332
Mailing Address - Country:US
Mailing Address - Phone:936-441-1133
Mailing Address - Fax:936-788-1156
Practice Address - Street 1:507 WACO ST
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-2332
Practice Address - Country:US
Practice Address - Phone:936-441-1133
Practice Address - Fax:936-788-1156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX336335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189863701Medicaid
TX189863701Medicaid