Provider Demographics
NPI:1770952145
Name:NEU LIMBS, LLC
Entity type:Organization
Organization Name:NEU LIMBS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-698-9377
Mailing Address - Street 1:4242 MEDICAL DR STE 2100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5641
Mailing Address - Country:US
Mailing Address - Phone:210-698-9377
Mailing Address - Fax:210-698-2544
Practice Address - Street 1:600 N MCCOLL RD STE 602
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-9335
Practice Address - Country:US
Practice Address - Phone:956-217-5015
Practice Address - Fax:956-683-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX395037001Medicaid