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General NPI Number Information
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NPI Number | 1104799105
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Entity Type | Organization
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Legal Business Name | GULF BIOMECHANICAL LABORATORY LLC
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 2222 MORGAN AVE
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City | CORPUS CHRISTI
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State | TX
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Zip | 78405-1948
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Country | US
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Telephone | 361-299-5983
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Fax | 361-299-5984
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Provider Business Mailing Address
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Address Line | 8801 TRADEWAY ST
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City | SAN ANTONIO
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State | TX
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Zip | 78217-6114
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Country | US
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Telephone | 210-495-3399
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Fax | 210-495-3393
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Authorized Official
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Title or Position | REPRESENTATIVE
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Name | KATHY A MYERS
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Credential |
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Telephone | 210-859-1288
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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 |
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License Number State |
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