MEDICARE: BAKER O & P ENTERPRISES INC

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	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	530894	OTHER	TX	BCBS
2	82011	OTHER	TX	NORTHWOOD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942398078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAKER O & P ENTERPRISES INC

Provider Business Mailing Address
First Line	:	501 HEMPHILL ST STE 151
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2229
Country	:	US
Telephone Number	:	817-332-7313
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 HEMPHILL ST STE 151
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2229
Country	:	US
Telephone Number	:	817-332-7313
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	BRADFORD GARDNER
Credential	:
Telephone Number	:	615-864-8783

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	03/11/2026

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