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General NPI Number Information
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NPI Number | 1053779231
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Entity Type | Organization
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Legal Business Name | CAPITAL PROSTHETICS & ORTHOTICS, LLC
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 08/22/2024
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Provider Practice Location Address
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Address Line | 1005 E SAINT ELMO RD BLDG 9
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City | AUSTIN
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State | TX
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Zip | 78745-1296
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Country | US
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Telephone | 512-916-9431
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Fax | 512-916-9435
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Provider Business Mailing Address
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Address Line | 1005 E SAINT ELMO RD BLDG 9
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City | AUSTIN
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State | TX
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Zip | 78745-1296
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Country | US
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Telephone | 512-916-9431
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Fax | 512-916-9435
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | JAMES BEARD
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Credential |
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Telephone | 405-900-4935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 1322
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License Number State | TX
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