Healthcare Provider Details

I. General information

NPI: 1396351573
Provider Name (Legal Business Name): BAKER O & P ENTERPRISES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1033 LA POSADA DR STE 130
AUSTIN TX
78752-3824
US

IV. Provider business mailing address

102 WOODMONT BLVD STE 120
NASHVILLE TN
37205-5249
US

V. Phone/Fax

Practice location:
  • Phone: 512-505-8887
  • Fax:
Mailing address:
  • Phone: 615-864-8790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: BRADFORD GARDNER
Title or Position: COO
Credential:
Phone: 615-864-8783