Healthcare Provider Details

I. General information

NPI: 1275441859
Provider Name (Legal Business Name): ORTHO PRO USA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16886 HAMMON WOODS DR
HUMBLE TX
77346-4659
US

IV. Provider business mailing address

16886 HAMMON WOODS DR
HUMBLE TX
77346-4659
US

V. Phone/Fax

Practice location:
  • Phone: 312-702-0752
  • Fax: 312-702-0752
Mailing address:
  • Phone: 312-702-0752
  • Fax: 312-702-0752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. GARY A CLOWERS SR.
Title or Position: OWNER
Credential:
Phone: 312-702-0752