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NPI Code Detail

MEDICARE: NEW LIFE PROSTHETICS AND ORTHOTICS

MEDICARE: NEW LIFE PROSTHETICS AND ORTHOTICS
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
1335E00000XProsthetic/Orthotic Supplier2TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1588650337
Entity Type Code : Organization
Provider Name (Legal Business Name) : NEW LIFE PROSTHETICS AND ORTHOTICS
Provider Business Mailing Address
First Line : 2013 WELLS BRANCH PKWY
Second Line : STE 207
City : AUSTIN
State : TX
Zip : 78728-6900
Country : US
Telephone Number : 512-252-7177
Fax Number : 512-252-7156
Provider Business Practice Location Address
First Line : 2013 WELLS BRANCH PKWY
Second Line : STE 207
City : AUSTIN
State : TX
Zip : 78728-6900
Country : US
Telephone Number : 512-252-7177
Fax Number : 512-252-7156
Authorized Official
Title or Position : ORTHOTIST PROSTHETIST MANAGER
Name : MR. SCOTT BOWDEN ATHA
Credential : LPO
Telephone Number : 512-252-7177
Provider Enumeration Date : 09/26/2005
Last Update Date : 04/23/2012

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AUSTIN, TX
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AUSTIN, TX
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Directions to “NEW LIFE PROSTHETICS AND ORTHOTICS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.