Healthcare Provider Details

I. General information

NPI: 1639296239
Provider Name (Legal Business Name): MEDICAL CENTER BRACE AND LIMB
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7110 CECIL ST
HOUSTON TX
77030
US

IV. Provider business mailing address

7110 CECIL ST P.O. BOX 301129
HOUSTON TX
77030-4904
US

V. Phone/Fax

Practice location:
  • Phone: 713-799-1177
  • Fax: 713-797-6561
Mailing address:
  • Phone: 713-799-1177
  • Fax: 713-797-6561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. NORMA LOPEZ
Title or Position: BILLING SPECIALIST
Credential:
Phone: 719-799-1177