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General NPI Number Information
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NPI Number | 1205931102
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Entity Type | Organization
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Legal Business Name | ORTHOTIC & PROSTHETIC TECHNOLOGIES INC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 05/10/2017
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Provider Practice Location Address
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Address Line | 8000 ANDERSON SQ STE 301A
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City | AUSTIN
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State | TX
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Zip | 78757-8421
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Country | US
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Telephone | 512-377-2323
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Fax | 512-374-9993
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Provider Business Mailing Address
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Address Line | PO BOX 650846
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City | DALLAS
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State | TX
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Zip | 75265-0846
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Country | US
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Telephone | 512-377-2323
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Fax | 512-374-9993
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Authorized Official
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Title or Position | REG COMPLIANCE SPECIALIST III
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Name | GRACE ANGELINE
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Credential |
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Telephone | 714-961-2102
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 656680000
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #3
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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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