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General NPI Number Information
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NPI Number | 1275675035
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Entity Type | Organization
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Legal Business Name | CALDWELL PROSTHETICS AND ORTHOTICS, LLC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 02/06/2008
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Provider Practice Location Address
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Address Line | 330 INDUSTRIAL BLVD 110
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City | MCKINNEY
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State | TX
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Zip | 75069-7305
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Country | US
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Telephone | 972-548-7707
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Fax | 972-548-7739
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Provider Business Mailing Address
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Address Line | 330 INDUSTRIAL BLVD SUITE 110
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City | MCKINNEY
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State | TX
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Zip | 75069-7305
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Country | US
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Telephone | 972-548-7707
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Fax | 972-548-7739
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. DAVID GLENN CALDWELL
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Credential | CPO
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Telephone | 972-375-3892
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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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 | 101229
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 1224
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License Number State | TX
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