Healthcare Provider Details

I. General information

NPI: 1366635351
Provider Name (Legal Business Name): ORTHOPEDIC ASSOCIATES OF CORPUS CHRISTI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5917 CROSSTOWN EXPY
CORPUS CHRISTI TX
78417-3504
US

IV. Provider business mailing address

5917 CROSSTOWN EXPY
CORPUS CHRISTI TX
78417-3504
US

V. Phone/Fax

Practice location:
  • Phone: 361-854-0811
  • Fax: 361-806-5040
Mailing address:
  • Phone: 361-854-0811
  • Fax: 361-806-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES W. BRECKENRIDGE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 361-854-0811