Provider Demographics
NPI:1851606370
Name:TMC ORTHOPEDIC, LP
Entity Type:Organization
Organization Name:TMC ORTHOPEDIC, LP
Other - Org Name:TMC ORTHOPEDIC, LP-BEAUMONT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:V
Authorized Official - Credentials:
Authorized Official - Phone:713-669-1800
Mailing Address - Street 1:4410 DOWLEN RD
Mailing Address - Street 2:SUITE 101A
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-6872
Mailing Address - Country:US
Mailing Address - Phone:409-892-2215
Mailing Address - Fax:409-892-2748
Practice Address - Street 1:1000 S LOOP W
Practice Address - Street 2:SUITE 150
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-4658
Practice Address - Country:US
Practice Address - Phone:713-669-1800
Practice Address - Fax:713-669-8330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TMC ORTHOPEDIC, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-09
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000452332BC3200X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX101337OtherTBOP