MEDICARE: T2 ORTHOPEDICS DISTRIBUTION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1396028247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	T2 ORTHOPEDICS DISTRIBUTION LLC

Provider Business Mailing Address
First Line	:	4300 SIGMA RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-4422
Country	:	US
Telephone Number	:	972-250-5897
Fax Number	:

Provider Business Practice Location Address
First Line	:	4300 SIGMA RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75244-4422
Country	:	US
Telephone Number	:	972-250-5897
Fax Number	:

Authorized Official
Title or Position	:	BILLING
Name	:	ADRIANNA VILLARREALL
Credential	:	RN
Telephone Number	:	972-250-5897

Provider Enumeration Date	:	09/27/2011
Last Update Date	:	09/27/2011

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