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General NPI Number Information
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NPI Number | 1487699138
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Entity Type | Organization
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Legal Business Name | NEW LIFE BRACE & LIMB ,LLC.
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 901 POST OFFICE ST
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City | GALVESTON
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State | TX
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Zip | 77550-5120
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Country | US
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Telephone | 409-763-0001
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Fax |
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Provider Business Mailing Address
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Address Line | 901 POST OFFICE ST
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City | GALVESTON
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State | TX
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Zip | 77550-5120
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Country | US
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Telephone | 409-763-0001
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Fax |
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Authorized Official
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Title or Position | PROSTHETIST/MEMBER
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Name | BOB EARL DRAEGER
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Credential | CPOLPO
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Telephone | 409-771-3461
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1744P3200X
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Taxonomy Name | Prosthetics Case Management
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License Number |
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License Number State |
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