MEDICARE: ORTHO 6, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1114173309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ORTHO 6, LP

Provider Business Mailing Address
First Line	:	11201 RICHMOND AVE # A-106
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77082-6653
Country	:	US
Telephone Number	:	281-598-6200
Fax Number	:	281-598-6201

Provider Business Practice Location Address
First Line	:	850 FM 1960 RD W STE H
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77090-3413
Country	:	US
Telephone Number	:	281-444-4713
Fax Number	:	281-444-6366

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. KEVIN DUANE HOLYFIELD
Credential	:
Telephone Number	:	713-660-8801

Provider Enumeration Date	:	08/07/2008
Last Update Date	:	08/07/2008

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