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General NPI Number Information
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NPI Number | 1780666081
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Entity Type | Organization
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Legal Business Name | BASIN ORTHOTIC & PROSTHETIC CENTER PLLC
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Dates
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Enumeration Date | 11/14/2005
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Last Update Date | 07/11/2024
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Provider Practice Location Address
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Address Line | 623 N SAM HOUSTON AVE
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City | ODESSA
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State | TX
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Zip | 79761-4434
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Country | US
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Telephone | 432-337-8880
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Fax | 432-337-8887
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Provider Business Mailing Address
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Address Line | 623 N SAM HOUSTON AVE
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City | ODESSA
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State | TX
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Zip | 79761-4434
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Country | US
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Telephone | 432-337-8880
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Fax | 432-337-8887
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Authorized Official
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Title or Position | OWNER
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Name | TIM C HOWELL
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Credential | LPO,CPO,BOC-OP
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Telephone | 432-337-8880
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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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